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Stephenie’s Classical Hodgkin’s Lymphoma Story

Stephenie’s Classical Hodgkin’s Lymphoma Story

At 26, Stephenie was nearing the end of her master’s studies at the University of Georgia when she developed some unusual symptoms like bumps on her neck. She thought nothing of it, but her sister pushed her to get examined which led Stephenie to make an appointment at her university’s health center. Her doctor was thorough in his exams and tests, which led to Stephenie receiving a Hodgkin’s lymphoma diagnosis as a young adult.

Her life rapidly changed as she found herself making appointments to begin cancer treatments while at the same time taking finals and writing her final term paper to finish her master’s program. Less than a week after graduating, she began chemo and would go on to try two other chemotherapy regimens as well as two stem cell transplants

Today, Stephenie celebrates 5 years of being in remission and shares her cancer story with us, including the importance of doctors providing individualized cancer treatments and care, dating while receiving cancer treatment, experiencing graft-versus-host disease, being a patient advocate, pushing on when cancer treatments fail, and her advice to others on their own cancer journeys.


Stepheni shares her classical Hodgkin lymphoma symptoms, treatments and remission
Stepheni shares her cancer journey timeline
Stepheni shares her cancer journey timeline

If I can help one person get through their journey, then sharing my story is the least that I could do.

Stephenie P.

Thank you to Pfizer for its support of our patient education program! The Patient Story retains full editorial control over all content.

This interview has been edited for clarity and length. This is not medical advice. Please consult with your healthcare provider for treatment decisions.


Table Of Contents
  1. Symptoms & Diagnosis 
  2. Chemotherapy
  3. Stem Cell Transplant
  4. Second Stem Cell Transplant
  5. Survivorship 
  6. Reflections 

Symptoms & Diagnosis 

Tell us about yourself

My name is Stephanie. I am a Hodgkin’s lymphoma survivor for 5 years now. I’m still getting back into a lot of my hobbies. I had to do a lot of after-cancer rehab. I have 2 beagles, spend a lot of time at home, cook a lot, and do a lot of baking.

When did your symptoms first occur?

It was back in 2015. I think it was around the beginning of the year, I started noticing I got these bumps on my neck. As the months passed by, they weren’t going away. I think I waited 3 or 4 months before I actually went to the doctor to check out the lumps in my neck. 

Stepheni's sister encouraged her to get her lump checked

I was at the University of Georgia at the time getting my master’s degree. I went to the university health center that they assigned to every student. I went to him and said, “I have these lumps on my neck and they’re not going away. I haven’t been sick or anything, so I don’t know what’s going on.” He asked me all these other questions like, “What other symptoms are you having?” I said, “Well, I don’t think I’m having any other symptoms really.” Then he started asking me questions like, “Have you been having night sweats?” I said, “Well, yeah, I have been getting really hot in the middle of the night.” He asked, “Are you sweating so much that you’re soaking through your clothes?” I said, “Yeah, actually. It’s never been that much before.” Then he asked me if I was feeling more tired than usual. I said, “I don’t know. It’s finals and I just ran a half marathon.”

I didn’t really take those things into account that those could be symptoms that all added up to something else. I don’t even know if I would have gone to the primary care doctor at all if my sister hadn’t pushed me to do it because I went to go visit her during that time and I said, “I have these lumps on my neck.” She was looking at them and she’s like, “You should get that checked out.” 

Examining the symptoms with tests

He wanted to do some other tests after that. I said, “Well, what could this be?” He listed off a lot of things that it could have been. I just remember the last thing he said was cancer. I was so surprised because he was just my university physician. I don’t know how many cases he gets like this or how often he sees something like this, but I’m really grateful that I was assigned to him because I feel like any other doctor would have been like, you’re young, it’s probably nothing. I was really grateful that he took it seriously. 

Stepheni's doctor examined her symptoms with multiple tests

He listed off a lot of things that it could have been. I just remember the last thing he said was cancer.

He gave me the next steps and he was very quick about it. I feel like a lot of times you’re waiting around for the next step. But he was like, “Alright, today you’re going to go and get more x-rays. Tomorrow I’m going to schedule you for this.” So there was no in-between time working with him. If I can give a shout-out to Dr. Kevin Sanville at the University of Georgia, he literally saved my life. I’m so grateful.

Accelerating testing due to imminent insurance changes

It was a complicated time for me because I had just turned 26, so I only had that month left of being on my parent’s insurance. I think that’s part of why he wanted to speed it up so that I could get all that testing done and it’d be covered. 

We did x-rays, I had my first CT scan, and then I had a follow-up with him where he went over all the results from those things. He said, “There’s a good possibility that this is cancer.” We had to move on to getting biopsies. 

Stepheni had to quickly receive tests with limited time left on her parent's insurance

It’s good being in a university town. There’s a lot of doctors, a lot of medical practices there. He sent me over to do the biopsies, we got the results back, and then he set me up with an oncologist who was in town. Luckily it was a practice that’s all over the state. They knew that I was graduating so I wouldn’t be there for my entire treatment, so they made sure to set me up with somebody I could still transfer easily with wherever I went.

Getting tested before beginning cancer treatment

I had 3 biopsies so that they could be certain. They took one out from my neck, from my underarm, and then I did the bone marrow biopsy and it moved really fast after that. To get me ready for chemo, they had to get all these other tests done to make sure that my body could handle the chemo. I had to do a pulmonary function test to make sure my lungs were good. I went to a cardiologist to get an echocardiogram to make sure my heart was good. There were a bunch of doctors I had to go to before. 

Stepheni received multiple tests before getting cancer treatment

I had to go see my dentist too. That really freaked me out because they said chemo can mess with your gums and your teeth. My teeth were expensive. If you ask my mom, she’ll say she paid $6,000 for my braces. I remember making an emergency appointment with my dentist. That was a crazy experience, going to your dentist and saying I need you to check me out because I’m about to go through chemo. 

My dentist was on top of it. Unfortunately, his sister was diagnosed with breast cancer so he knew when things happen, they have to happen fast. My dentist had the office on vacation that week and he was like, “Everybody’s out of the office.” I was freaking out, so he opened the office just for me and he did everything himself. I left with a huge bouquet of flowers, too. It was very nice.

Describe being told you have cancer

The way I found out I wish was different because it was actually from my surgeon who did the biopsies. He called me a few days afterward and said, “Yeah, we got the pathology and it looks like it’s Hodgkin’s lymphoma. You probably want to follow up with your oncologist.” 

I was sitting in bed recovering from the biopsy, so I was just on the phone with him. I didn’t really know what to do. I was at my apartment by myself at the time. My roommate wasn’t home so the first thing I did was I called my sister. She was living in New York at the time and she was working at a corporate job so she knows that when I call, she needs to answer. She said that she was in a meeting, but she ran out into another conference room to take my call. 

» MORE: Reacting to a Cancer Diagnosis

I didn’t know what to do because I didn’t get the news from my oncologist, so I just waited for my roommate to get home. We made a plan because I was like, I know a lot of people are going to want to know what’s going on, but it’s going to be really frustrating for me to keep telling them over and over and getting all the people’s reactions. She was like, “I’ll help disseminate the information so that you don’t have to deal with all that.” Then she took me out to dinner. 

I did go to the oncologist the next day so I didn’t have to wait that long before we figured out what the next steps were. I just really wish that the surgeon had done the correct procedure and waited so that I could get the news in my oncologist’s office.

Chemotherapy

Where did you receive medical care?
Stepheni's first chemo session

I started out at the office that they had there in Athens, then eventually I graduated and had to move out of my apartment. The easiest thing was for me to move back home with my parents. Luckily, there was an office that was 15, 20 minutes from my parent’s house so I transferred over to them.

Describe your first oncologist visit

There’s no such thing as “good cancer.”

That was a blur. I had two of my college friends come with me because I was away at school, so my parents didn’t come. They came with me to absorb all the information that I could not absorb. They said, “We want to start treatment as soon as possible.” They gave me the whole “Hodgkin’s lymphoma is a blood cancer, so we’re really good at curing those. You’ll do 6 months of chemo and you’ll be good.” I got that line, “You got the good” cancer. That’s all I remember.

Stepheni was told she has the good cancer
Stepheni's friends came with her to her first appointment
Her friends were able to absorb the information she couldn't in that moment

There’s no such thing as “good cancer.” There are so many different types of cancer and everybody’s journey is different. No matter what, even if you don’t have to do chemo or you don’t have to do radiation, some people have to get surgery. It’s different for everybody and it’s hard on people in different ways. There is nothing good about getting a cancer diagnosis, so I can’t believe that doctors still say that to people. I guess it’s their way of trying to make you feel like everything is going to be okay but there’s a different way that you can do that.

Juggling finishing school and beginning treatment

After that, we had to schedule my port placement, and then they talked about my chemo schedule and doing 6 rounds of ABVD which would take 6 months. I feel like it was different for me because I was in my master’s program and I still had to graduate. I had to reschedule all my finals with my professors and it was my last semester. I had to do my final term paper. 

There were all these things that we had to do for graduation, and I was getting inducted into an honor society. Not only did I have to start scheduling all these appointments and surgeries, but I had to also try to do school on top of that. It was a little hectic. Luckily my professors were really understanding, so it all worked out.

I graduated Friday and I started chemo on Wednesday.

Stepheni juggled finishing school and beginning cancer treatment
Stepheni began cancer treatment the same week she graduated
Stepheni's doctors allowed her to delay chemo until after graduation

They actually wanted me to start chemo before graduation. I think graduation was May 8th. I remember that because it was my sister’s birthday and they wanted to start chemo the week before that. I was like, “Can I just graduate first and then start chemo?” Luckily, they said we can do that. I graduated Friday and I started chemo on Wednesday.

Did you have any side effects on chemo?

Starting treatments, I really did not know what to expect at all. I just went. It wasn’t as bad as I thought it was going to be. It was pretty easy. I arrived at the cancer center, then they knocked me out with diphenhydramine. I woke up and I was done for the first few months. The side effects, luckily for me, were very little. 

I did lose my hair after the first month of treatment. I was putting off shaving my head because my aunt is a hairstylist and I wanted to try cool things before I had to shave my hair off. We did cute short hairstyles and we did purple hair for Hodgkin’s. It was fun. 

» MORE: Hair Loss and Regrowth After Chemotherapy  

I didn’t get too nauseous with ABVD. I think the first time my nausea got really bad was my third treatment. I did get really tired. I tried to stay active. I had a very busy schedule all the time just because I was in graduate school. I was used to being on the go a lot so I still kept a pretty busy schedule. Then after a month or 2, I had to start pulling back because I was getting so tired all the time. I’m not a nap person at all, but I would sleep so much. I think those were the biggest side effects for me during chemo.

Changing chemo treatments
Stepheni began ICE chemotherapy

The first protocol that they did with me was a scan and they said that nothing had really improved, so we had to move on to the second round of treatment, which was a different chemotherapy regimen. We did a scan after that too, and it still showed no improvement.

The second chemotherapy treatment that they had me on was the ICE regimen. That stands for all the all the chemo drugs they give you. That was tougher because it was multiple days of chemotherapy instead of once every 2 weeks. It was more tiring because you’re getting more drugs.

Learning to live with uncertainty 
Stepheni had to learn to live with uncertainty

I was just rolling with the punches at that point. Before I got diagnosed, I was a really organized, scheduled person, and I realized really quickly that that wasn’t going to work for this. I had to learn how to live with ambiguity, uncertainty, and, whatever they threw at me. I took it and figured out a way forward. I was like, alright, let’s keep rolling. What’s the next step?

Stem Cell Transplant

Considering a stem cell transplant after unresponsive chemo

That’s when they started talking about possibly having to do a transplant. I got all this research about transplants. I was hooked up with The Leukemia & Lymphoma Society, so they gave me a lot of information and people to talk to about transplants. 

Stepheni was unresponsive to chemo
Her doctors considered stem cell transplant

This was something I’d never heard of before. I’d heard people get live, solid organ donations, but I didn’t know anything about stem cell transplants or bone marrow transplants. It was a lot of talking to people and getting their experiences. 

I was on brentuximab during that time just so that they could keep everything at bay. Then they referred me to the transplant oncologist so it was more appointments and more education on what stem cell transplant would be and how to get me ready to get to that point.

Preparing for a stem cell transplant
Stepheni had to give herself Neupogen injections prior to stem cell transplant

The first transplant I got was an autologous stem cell transplant. That’s when they extract your own stem cells from you and put them back into you. I’m not a sciencey person, so I try to understand it as best as I can. I had to do these self-injection shots of filgrastim because that’s what makes your stem cells grow. I did that for 5 days. After that, you have your collection day where they take all of your stem cells out. It involves sitting in a chair all day and it’s like giving blood, but they put it through this machine that sorts out all the blood products and all the stem cells, and then it puts the blood back into your body. 

It’s a long process and I was there for a long time getting my stem cells collected. There’s a certain amount that they need to collect from you before they start the rest of the process. I was hoping that they had enough that I only had to do one collection day because I heard people had to do 2 or 3 days of collections. I only had to do one day of stem cell collection.

Describe your experience with getting a stem cell transplant

That was tough to get ready for the stem cell transplant. Not just the stem cell collection, but there are days of high-dose chemotherapy that you have to go through. It was different drugs that they gave me at that time. Those were long days in the chair at the hospital. I think there were 3 days of high-dose chemotherapy before my first transplant. 

The thing that was the toughest was for all of the transplant stuff, they don’t use your port, they use a tri-catheter port because you need so many things going in you at one time. I had to get that placed too. That was part of getting ready for the stem cell transplant. After you get that placed, you cannot go into public places anymore. You can’t drive. After I got that placed, I was dependent on everybody around me. You have to have a caregiver 24/7 and that’s so hard for a lot of people to find. Luckily, my mom was able to take FMLA off from her work so that she could stay with me. 

Then we had another obstacle where we were about an hour away from Atlanta. My mom could not drive that far, so not only did I have to have a caregiver, but I also had to have a driver who could take me to the hospital every day. You’re at the hospital every day for all the pre-transplant stuff before you’re even admitted to the hospital. 

It was crazy. I had to put out this blast to all my friends and say, “These are the days I have appointments. I need a driver in the morning, and a driver in the afternoon.” We had this calendar where people would sign up. Georgia is pretty spread out, so people were driving from the other side of the state to come pick me up and take me to the hospital. It was literally the whole village that needed to help me. That was really tough because I’ve always been on an independent streak. Begging people for that help, I felt so bad.

Did you have a hospital stay?

The first stem cell transplant was rough. There are so many protocols when you’re in the hospital. Since I didn’t have that transportation back and forth to the hospital every single day, I was admitted for the first 100 days of my transplant, so I was in the hospital for a long time. It was really rough because you can’t sleep. Every 6 hours there was something that somebody had to do. Every 12 hours there was something somebody had to do. I had to get woken up in the middle of the night just to get blood work done. It was impossible to get any sort of rest in there. 

I think about halfway through, my port actually got infected so they had to remove that. I had to spend the rest of the time in the hospital getting stuck with needles every day so my veins just got shot. I remember one night it took 3 nurses and 17 sticks to get my blood sample for the night, and every night, you had to do blood work. It was intense but I had somebody visit me every day. 

Stepheni's friend visited her everyday at the hospital
Stepheni felt alone when no one was at the hospital
Her hospital stay was extensive

My best friend would come every day after work. She would be there with me at the hospital every night. I just love her so much. She really got me through that. She came on the day of the transplant and she decorated my room. She put photos everywhere. I had a lot of people stop by that first day that I actually got my transplant. It was nice that I always had visitors, but when they leave and you’re there by yourself in the middle of the night, it’s tough.

Is it normal to stay in the hospital post-transplant? 

I think usually you just stay in the hospital because, after your transplant, your white blood cell count goes to 0. Your immune system has to build back up and usually, they will discharge people after your immune system has built back up. Getting that blood work every day and then hearing the numbers, you’re just like, oh, I still have so long to go, was tough.

Stepheni's cancer metastasized after her first stem cell transplant

After my first scan post-transplant, they found that the cancer metastasized to my bone, especially in my spine.

What were the results of your stem cell transplant?

It was clear very soon after that it hadn’t been the effect that they wanted. After my first scan post-transplant, they found that the cancer metastasized to my bone, especially in my spine. I actually had to go to radiation after my transplant which was another experience.

Stepheni had to go through radiation after her metastasis
How did you process your cancer metastasis? 

I don’t want another young Asian girl to go through so much that she doesn’t need to just because we have to be treated in facilities that weren’t made for us.

Stepheni emphasizes the importance of doctors individualizing care

It was tough to hear, but I feel like what’s really hard is getting other people’s reactions to it, especially my parents and family members. My parents are refugees from Vietnam, so there’s a language barrier and they don’t totally understand everything. Then there’s that constant thought in their head, Why is this happening? 

It was a lot of trying to manage other people’s emotions really. I thought medicine in the US is made for people’s genetics who were born here, who are from here. Medicine was not built for people like me whose genetics are from across the world where things are different. That’s something that doctors haven’t really realized, that an Asian patient reacts differently to a lot of things than a Caucasian patient would. I felt that it was important for me to continue so that they could figure it out. I don’t want another young Asian girl to go through so much that she doesn’t need to just because we have to be treated in facilities that weren’t made for us.

Second Stem Cell Transplant

Getting a second stem cell transplant

It was obvious that we had to move to the next level of stem cell transplants. The first transplant I had was an autologous stem cell transplant because they were getting the stem cells from my own body. The second transplant that I got was an allogeneic stem cell transplant, which gets stem cells from a donor. 

Stepheni had to undergo a second stem cell transplant

That was the next step, was to do the transplant with the donor. That’s the part that scared me because I’ve worked with Be The Match before, and I was part of a big push for getting more diverse donors into the registry. It was a little scary because I knew that there weren’t going to be a lot of options for Asian people.

Finding a stem cell donor
Stepheni had to find a new stem cell donor

Once again, my community came through and all my friends who were still at the university had a big Be The Match registry drive targeted towards getting Asian people to sign up. I can’t imagine being in that position where you’re depending on somebody else to save your life. But there’s people out there, they’re just not in this registry and you can’t find them. That was a scary part of it.

To find a donor, they ask that any family members who want to see if they’re a match for you can do that. My mom got tested and my sister got tested and I wasn’t really thinking that it would work out because the way that genetics work, I only have one sister. The chances that she would be a perfect match for me were not great. Then at best, my mom would only be a half-match for me so they could do half-match transplants, but the chances are of course going to be better if you have a 100% match. Luckily me and my sister are 100% matches.

Describe discovering your sister was a match

I remember getting the call when I was at work. Usually, when I was at work, I would pick up my phone and close my office door and immediately people would get worried. I picked up the phone and it said Emory calling. They said, “Your sister is a 100% match.” I started screaming. 

After I got off the phone, I opened my office door and all my co-workers were standing there and they were like, “What happened?” Luckily it was good news, it was exciting. I don’t know if my sister already knew, so I called her too and said, “They just called and told me that you’re a 100% match.” She was really excited too. That was a huge relief because I really didn’t think that she would be a perfect match. People said, “You and your sister are basically twins.”

Stepheni discovered her sister was a  100% match
Stepheni's sister was able to donate her stem cells
Stepheni's care team proceeded with an allogeneic stem cell transplant
Switching medical care

I’m really glad that I advocated for myself and said this isn’t working for me.

I didn’t really have a good experience with my first transplant. The clinic was very full. It was very rushed. If I had questions, I felt like I couldn’t ask anybody. It wasn’t a good experience, so I didn’t want to do a second transplant with them. 

I went to a different clinic to get a second opinion, and I went through my second transplant with them instead. I think that was a big change in my care. I’m really glad that I advocated for myself and said this isn’t working for me. I need to be somewhere else because my second transplant was the same process. 

» MORE: How To Be A Cancer Patient Advocate 

Stepheni advocated for herself and switched medical care
Receiving radiation before stem cell transplant
Stepheni went through 4 radiation sessions prior to her next transplant

My sister had to fly in and she did all the stem cell collection. While she was doing that, I was doing high-dose chemotherapy still. Then I also had to do 4 sessions of total body radiation before the transplant could start. I was also admitted to the hospital before my actual transplant started. That was nice because I would already be there. I didn’t have to be transported back and forth being so tired from total body radiation all the time.

Did you develop graft-versus-host disease?

I had a better idea going into it since it was my second one. It had different challenges than the first one. With my second transplant, since it was from a donor, that’s where graft-versus-host disease comes in. My graft-versus-host was mainly in my skin and in my GI tract. It affected my eyes a little bit. Those were the worst side effects. 

Stepheni developed graft-versus-host disease

With the skin, it gets really red, itchy, flaky, and inflamed. They gave me this steroid cream and I was piling tubs and tubs of steroid cream on my arms and legs. It was everywhere. Arms, legs, stomach, back. Luckily, it didn’t get to my face. I didn’t even think about that. 

My eyes would get really dry. Even now, really bright sun or bright lights, my eyes are super sensitive now. Along with those problems, I had that stomach ache feeling all the time. I couldn’t eat anything really. It was tough to get through that. Eventually, once your body starts accepting the donor cells more, the symptoms go down and they give you medication to manage it. 

Taking maintenance medication to retain donor cells
Stepheni was on maintenance medication to maintain donor cells

After that transplant, there were several medications that I had to be on for a few years afterward to make sure that my body wouldn’t reject the donor cells. Everything eventually calmed down with all of that. It was a lot of maintenance treatments with the medications and they’ve continued me on brentuximab. I think that was their miracle drug at the time. Everything cleared up. I was warned that, if I get sick the symptoms might flare up sometimes, which I’ve seen this past year. My skin has gotten really dry again. Luckily, nothing as bad as it was before.

What was the prep like for your second stem cell transplant? 

The stem cell transplant, with all the prep for this second stem cell transplant, they actually have to get you into remission before they do the stem cell transplant which I feel like they should have done with my first transplant, which is also a reason I decided to go to another clinic. 

Stepheni prepped for her next stem cell transplant

With all the high-dose chemotherapy, we did the scans and found out I was in remission. That’s when they scheduled me for my stem cell transplant. It was a little bittersweet because you get the news that you’re in remission, but then you still have to plan for another 100 days in the hospital.

Survivorship 

How did you react to hearing you were in remission?

I actually just got a phone call from my doctor because I had gone in for the scan and all the blood work and she didn’t want me to wait until my next appointment all the way in Atlanta. She gave me a call and told me that there was nothing they saw. They didn’t see anything on the scans so she was like, “We can declare you in remission and get you ready for your stem cell transplant.” 

Stepheni got engaged when she learned she was in remission

I still was skeptical because I was like, I’m in remission, but I still have to do this stem cell transplant and the last stem cell transplant didn’t really go as expected. I knew that I just had to keep going and whatever the result at the end would be we would just play it from there.

Describe your recovery process post-transplant 

It was tough. There were a lot of quarantine days because your immune system is still so low that you don’t want to be in a lot of public places. I was recovering at my parent’s house. My mom took more time off of work to see me through the second stem cell transplant. It was a lot of trying to get my appetite back up, get active, and get back into normal activities. There’s also a lot of follow-ups. Even after I got discharged from the hospital, I was still going there. It started out once a week and then after a while, twice every 2 weeks, and then eventually you get to be discharged forever.

Stepheni ran a half marathon prior to her dx
Dating during cancer treatments

I met my husband through a popular dating app that my friend had signed me up for. It was about 6 months after I was already in treatment. I was already very much in my cancer era. I didn’t really want to date, but my friend forced me out there. 

I was very straightforward. I was like, “I have cancer. I’m still going through treatment.” He was very receptive and understanding. The first time we met was in the wintertime, so I was wearing a hat. He was like, “Just take your hat off.” I was like, “No, I’m good.” It was an interesting time, but I think we were only dating a few months before I went to my first transplant. It moved very fast because of where I was in my treatment. That’s why I was so straightforward when I first started talking to him because I knew that I had to do this and he couldn’t get in the way. Either he was in or out. I didn’t have time to waste and luckily he was on board.

I was really grateful for that because I was going through grad school and dating during college and school is completely different. I felt like I was in a place where life was becoming very real. I knew that I didn’t have any time to play around anymore. I needed something serious. It really weeded out everybody. It was easy because, once that C word comes up, people either run to help you or they run away. That sorted out a lot of things in my life, not just in the dating department, but also with friends and unfortunately some family.

Stepheni began dating during cancer treatments
Stepheni felt dating while having cancer helped her weed out people who were not serious
Stepheni eventually married
How long have you been in remission? 

I’ve been in remission since February 2018, so it’s been a little over 5.5 years.

What was life like after remission?

After my second stem cell transplant and knowing that I was in remission, I started to try to get back into the swing of things and become a productive member of society again. I wanted to use my master’s degree that I had to finish before I started treatment. 

» MORE: Learn More About Cancer Remission

Stepheni had a long rehabilitation post-cancer

It was a lot of learning that I had to do dealing with being a cancer patient, even though I don’t look like a cancer patient. Trying to find work that I was able to do. Even going through getting married and having a wedding. There are a lot of things that as a cancer patient, I had to take into account. It does become part of all these other parts of your life in some way, shape, or form.

What is survivorship to you?

Some people who haven’t had cancer will say that once you’re in remission, you’re all good. That’s really not how survivorship is. There’s a lot that goes into it. Not only did I have to do a lot of physical therapy, but I had to do a lot of mental therapy. Talking to my therapist all the time, and working on my mental health were very important. 

Cancer does become intertwined with a lot of aspects of your life if not all of them. Just because you’re in remission doesn’t mean that you don’t have to stop thinking about it. You just don’t think about it as much. There are still triggers and obstacles that you come across post-cancer that will remind you that was something that you went through and that you have to do things a little differently now maybe because of what you’ve been through. 

» MORE: A Guide to Cancer Survivorship Care Plans for Hodgkin Lymphoma Patients

Stepheni discusses what survivorship means to her
Stepheni has gone through therapy during her cancer treatment
Stepheni can't be on her feet too long post-cancer

There are things that I think about now whenever I’m doing something. If I’m traveling, I can’t be on my feet too long, so sometimes I’ll have to get a wheelchair at the airport. There are different things that you have to adjust to. The important thing is that you’re still here, you’re still alive, you’re still doing it. I guess cancer just likes to remind you to appreciate life a little bit more.

Did you preserve fertility?

I did see a reproductive specialist before my first chemotherapy session. It wasn’t stressed to me the importance of doing any kind of egg freezing because I had a blood cancer and a lot of patients are able to do the first round of treatment and move on with their lives and conceive and have children. That was the mindset that they led me to believe. 

With the timing of everything, there just wasn’t enough time to think about doing egg freezing. I was young at the time, so I was like, I’ll bounce back. Then, of course, my treatment did not go as planned. Unfortunately, I didn’t have that to fall back on.

Stepheni discusses fertility post-cancer

That was another thing that I was very direct about when I first met my husband. I was very clear that not only do I have cancer, but there’s probably a good chance that I won’t be able to have children either. He was very receptive to that. His family has a lot of adopted children in their family. He was like, “I know all about adoption and I’ll be on board just as long as you’re healthy.” 

We did meet with another reproductive specialist after I was in remission and we did testing to see if I could conceive. That was when I was told that I was already in menopause, which is probably why I was sweating so much at night. There was an option to do an egg donor and have a surrogate, but we just didn’t feel comfortable going that route so our plan is to adopt. There’s still a lot of research that we’re doing and a lot of saving up that we’re doing because not being able to conceive your own child is very expensive. That’s our eventual goal is to adopt a child.

Reflections 

The importance of understanding that everyone’s cancer journey is unique

I think the most important thing that I learned was that there is no comparison with cancer. Every person is different. Every journey is different. Even if you have the same exact diagnosis as somebody else, you could be going through completely different things. It’s your own journey and you have to figure out a way to keep going no matter what. Nobody else is going through it but you and it’s a lot of trying to make people understand, a lot of managing emotions. I didn’t realize that when I told people I had cancer I would have to comfort so many people. 

It’s very eye-opening to see who really cares about you. It really tells you who’s going to be a true friend. Cancer is the only thing that’s not going to lie to you. It’s going to tell you how it is with everybody. It’s your own journey. You can have bad days. 

I hated when people told me that I needed to stay positive. Some days you just want to curse the world and be in your bed all day. Take what you need. Do what you need to do. Nobody else knows what you’re going through, so you have to advocate for yourself. Let people know. I like to share my story because people look at me and say, “You’re young, you’re healthy,” but they don’t know what it took to get there.

Even if you have the same exact diagnosis as somebody else, you could be going through completely different things. It’s your own journey and you have to figure out a way to keep going no matter what.

Stepheni emphasizes understanding everyone's cancer journey is different
Learning to listen to your body

I’ve been extra careful nowadays, especially post-COVID. I live in Georgia. It gets really hot, so I will sweat at night, but sometimes it’ll be a really hot day and I might sweat a lot that night. It’s a trigger that reminds me that this is what happened last time. Be on the lookout. That’s one of the things that cancer has taught me is how to listen to your body and what it’s telling you. I find myself very much more aware of how my body is feeling. 

Since the beginning of this year, I’ve had this lymph node that my husband will catch me touching on my neck where my other lymph nodes were. I subconsciously check myself all the time. Every little thing can be triggering. It’s really hard to get out of that mindset. My doctor has told me several times, “That’s just an overreactive lymph node. You’re going to feel it. It’s nothing to worry about.” But I made her schedule me for a scan. 

Stepheni emphasizes listening to what your body is telling you

That’s one of the things that cancer has taught me is how to listen to your body and what it’s telling you.

I think it’s important to listen to your body, but also recognize that sometimes a cold is just a cold. I have this trust in myself now where I know that this could be just a cold, but maybe this is something else. I think there’s some different feeling in your body that lets you know, this is not normal. As long as I don’t get that feeling when I get a cough or when I get a cold, I’m good, but I think that one overreactive lymph node really freaked me out because I wasn’t used to that.

Being a patient advocate

With all the follow-up care and meeting with different doctors, there is a lot of educating them on how to treat a cancer patient, a lot of repeating questions, and a lot of explaining to them what your scars are and what your radiation tattoos look like. I think it’s also a good learning experience for doctors who haven’t had to deal with young cancer patients. 

Stepheni emphasizes being a patient advocate

I have had a lot of doctors who, after meeting me, they’ll go do their own research about how to best provide care for a cancer patient. It’s frustrating having to retell your story all the time when you know that they could just read your history, but my history is so long that it’s just one of those things that you have to deal with every time you see a new doctor.

Even the form that you fill out when you get to the doctor’s office is like, “Do you have a history of cancer?” [I mark] yes, but they look at my age, and because I’m Asian I don’t look like I’m 34. They look at me and they’re like, “She’s young, I don’t need to check out these sections.” Then later when I tell them “Yeah, I’ve had cancer,” they’ll bring up that page and say, “Oh yeah, you marked it here.” I hope it brings awareness so that they make sure that they read the entire chart before talking.

I haven’t had any other major issues where that would be a problem. But there are some things when it comes to them prescribing medications and things like that, they find out that I’m on all this other medication and then they’ll realize, “Oh yeah, we’ve got to find something that won’t react to these medications.”

Do you still follow up with doctors post-remission?
Stepheni has regular oncologist visits post-cancer

I still have a regular medical oncologist that I see every so often. I think since I was recently discharged from my transplant oncologist, those appointments will probably go away. I do have to keep up with the cardiologist because the treatments are hard on your heart, especially being a young patient. There’s so much time for any radiation scarring that could become worse over time I have to continue to follow up with a cardiologist, a pulmonologist, and a dermatologist since my skin was so bad.

Rehabilitating after cancer

When I was getting diagnosed at first, I thought that I was going to be getting chemo and that was it. Chemo affects your entire body, so you have to continuously make sure that the rest of your body is still able to handle the treatment. There’s a lot of monitoring every part of you, even things I didn’t know that they did. I didn’t know that you could get a CT scan of your brain. 

It was a lot of different tests and things like that even post-treatment trying to rehab from cancer. I had to do a lot of physical therapy. One of my medications was giving me really bad hand tremors, so I had to do a lot of hand exercises and relearn how to write. Even simple things that people take for granted, like being able to sit up from a sitting position, or stand up from a sitting position. I had to practice that so many times because I was falling over. It’s a lot of recovery.

Stepheni discusses rehabilitation post-cancer

I still can’t be as active as I used to be. Before I started treatment, I ran a half marathon, and I don’t even think I could walk a mile now. It’s a lot of recuperation from treatment.

What have recent scans shown?

I’m clear. Since that last scan for remission, they’ve been monitoring blood work. If anything was wrong with my blood work, then they would move to scan. Luckily, it’s been good.

The importance of sharing your cancer story

If I can help one person get through their journey, then sharing my story is the least that I could do.

Stepheni encourages people to share their cancer stories

A lot of people ask me why I like to share my story so much and why I’m so open about what I’ve been through, and what I’m going through. When I was getting diagnosed, there was really nothing that gave me that personable experience of what it’s really like to go through and that’s why I like to share my story. I was trying to find people’s stories online to see what it was like, and I could not find anything. I think it’s really important to share your story, and what you’re going through, and it really helps people not feel so alone. 

I can’t name a lot of young adults or Asian patients. I really like to advocate for people who have the same background as me because it is a very grueling process. I feel like a lot of research needs to be done on different kinds of cancer care depending on your genetics. I want people to be able to find my stories and what I have to say because it’s so much more comforting hearing it from cancer patients themselves. If I can help one person get through their journey, then sharing my story is the least that I could do.


Thank you to Pfizer for its support of our patient education program! The Patient Story retains full editorial control over all content.

This interview has been edited for clarity and length. This is not medical advice. Please consult with your healthcare provider for treatment decisions.


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Categories
CAR T-Cell Therapy Chemotherapy Diffuse Large B-Cell (DLBCL) methotrexate Non-Hodgkin Lymphoma Patient Stories R-EPOCH Treatments

Sammie’s Stage 4 Diffuse Large B-Cell Non-Hodgkin Lymphoma Story

Sammie’s Stage 4 Diffuse Large B-Cell Non-Hodgkin Lymphoma Story

At age 21, Sammie began experiencing new and unusual symptoms every few weeks. Symptoms ranged from chest pain, back pain, and difficulty swallowing to developing a bump on her neck and experiencing extreme night sweats. Multiple urgent care visits resulted in her being told by doctors that her symptoms were nothing.

Months after her symptoms first began, her face became swollen which led her to the ER. Blood work revealed that none of her levels were within range and a biopsy uncovered a stage 4 diffuse large B-cell non-Hodgkin’s lymphoma diagnosis. 

Sammie shares her cancer story with us, including her experience with medical gaslighting, how she learned to trust herself and be a patient advocate, the challenges she faced of being a young adult with cancer, her experience with chemo and CAR T-cell therapy, the importance of finding a cancer community and her advice for those on their own cancer journeys.

Sammie shares her DLBCL symptoms, treatments and more

Stay strong and fight as hard as you can because it’s so, so worth it.

Sammie F.

This interview has been edited for clarity. This is not medical advice. Please consult with your healthcare provider for treatment decisions.


Symptoms & Diagnosis 

Tell us about yourself
Sammie was diagnosed with non-Hodgkin's lymphoma over a year ago

My name is Samantha. I was diagnosed with diffuse large B-cell non-Hodgkin’s lymphoma just over a year ago. I am from a small town. I like hanging out. I just got a dog which has been super fun, and I’m back to college now studying social work.

What were your initial symptoms?

Back in November of 2021, I started getting chest pain, and I really thought it was my heart because it was on my left side. Every time I took a deep breath, I felt it. Right after I felt it, I went [to the doctor] and they did a few heart tests and told me that everything looks pretty normal. They did EKGs and x-rays and sent me home. 

A couple weeks later, it was still happening. I went in again and they thought that I had pulled something in my chest or said it was anxiety, and said it was nothing. Again, they did a few more tests. From then on, it was every couple of weeks, a new symptom started to develop. The next was my back was hurting super bad. That’s when they sent me to the chiropractor and thought that I had scoliosis. From there, I started developing a bump on my neck and I was having a hard time swallowing my food. I go in again and they say it’s probably just an infection, they don’t think it’s anything and they kept sending me home with steroids or something to ease the pain. It wasn’t long-term, it’d make me feel good for a couple days and then something else would happen.

It wasn’t until the end of May, I woke up, my face was super swollen and puffy, and I could barely open my eyes. I went to urgent care again. They tested me for mono and strep and said that I was negative and that it’s probably nothing, sent me home with steroids again. Throughout this time, I’m having extreme night sweats, fatigue, sleeping all of the time, and my stomach started to hurt. I started vomiting. 

Sammie's first major symptom was chest pain
Getting a cancer diagnosis 

It was advocating for myself and my parents advocating for me that I was able to get a diagnosis.

Sammie received a diagnosis due to her and her parents advocating for her

I went to the ER and they finally started looking at me more seriously, but they still were looking at me like “You’re 21 years old. You don’t have any health history. We really don’t think that it’s anything, but we can do tests if it’d make you feel better.” 

It was advocating for myself and my parents advocating for me that I was able to get a diagnosis. Finally, when they took my blood, which wasn’t until June, none of my levels were in range. That’s when they started doing the ultrasound and the CT scan and from then on it was, you have cancer.

Processing A Cancer Diagnosis 

Did you anticipate having cancer? 

From being in the hospitals and going to see my primary doctor, nobody had said one thing about cancer. That was never brought up at all. If it weren’t for myself Googling my symptoms, which everybody says not to do, but I diagnosed myself before any medical professional diagnosed me. I was saying, “I’m pretty sure I have lymphoma.” I had every single symptom. 

Sammie believed she had lymphoma before diagnosis
She experienced months of medical gaslighting prior to diagnosis
Waking up with a puffy face led Sammie to go to the ER

I had that ultrasound on my neck and that didn’t look good. Two days later, I had my CT scan and within a half hour of the scan, they called me and said, “We think you have lymphoma. You need to go to the hospital.” In the back of my head, I knew something was off. I knew it wasn’t going to be good, but I wouldn’t think that I actually had it.

How did you react to your cancer diagnosis? 

It was a lot. It happened very quickly and it changed very quickly. I think that a lot of people might have tests for a couple of weeks at a time, thinking that they have cancer. But for me, it was like no one had expected me to have cancer. I don’t know how because I had every single symptom. But because I was healthy and had no complications ever, nobody expected it. My life changed very, very quickly and it was very scary.

Her life changed quickly after diagnosis

I was saying, “I’m pretty sure I have lymphoma.” I had every single symptom.

»MORE: Reacting to a Cancer Diagnosis

Describe the medical gaslighting you experienced 

I felt like every time I went back, I’m just saying the same things over and over and over again. Every time, I would tell them every symptom from November that I had and it was something new every couple of weeks. It started with the chest pain, then the back pain, then the lump, then vomiting and getting sick, being so tired, and super intense night sweats. They would just say, “Oh, you probably just had a fever and you broke your fever.” But it wasn’t like that. It was really, really intense night sweats. It was super frustrating. 

Doctors assumed Sammie was fine each time she came in with a new symptom

I’m super grateful that I had my parents advocating for me too, because I was starting to doubt myself. I’m like, am I just being dramatic? What is going on? I’m not one to complain about stuff like that. I knew deep down, something’s definitely wrong, but when you’re constantly being told you’re fine, nothing’s wrong with you, you start to believe it.

Chemotherapy 

Beginning chemotherapy 

Once I got to the hospital, I was admitted into the ER and then they sent me up to oncology. Still, at that point, nobody had answers for me. Nobody really knew what was going on. I was admitted on June 22nd and I was there the next 11 days. We had to wait a couple days because of the biopsy and you have to wait for results. Basically, they had a set plan of what we were going to do. 

»MORE: Chemotherapy FAQs & Patient Stories

The second I got my official diagnosis, we started treatment right away. Starting treatment, within the first hour of chemo, my bump was completely gone on my neck and I instantly was starting to feel better. It was crazy how fast that happened. They knew exactly what chemo to do. I did the R-EPOCH regimen. It was 5 days of chemo, 5 days straight, and I would go in on Wednesdays to get my bag changed. I could take my chemo home with me, which was super nice, but it just wiped me out completely. It made me super, super tired. 

My body handled the chemo pretty well, I think because I’m young, but it made me super exhausted. I did 6 rounds of that R-EPOCH chemotherapy, and then I did 2 rounds of methotrexate.

Sammie was R-EPOCH chemo
After R-EPOCH, she was on methotrexate
Sammie discusses the side effects she experienced on chemo
What side effects did you experience from chemo?

The first round of chemo that I had, they discharged me from the hospital. I was doing good at that time. The next day, I got super, super sick. I was super dehydrated and could not stop vomiting.  At this point, they didn’t send me home with any nausea meds or anything. We didn’t know what to do. I couldn’t keep any of my meds down. 

I instantly started feeling better because I didn’t realize how sick I had been the whole year prior. Finally, my body was being treated for what it needed for so long.

The next day I was home from the hospital, I went back to where I get chemo at. They pumped me with fluids, but other than that, I handled the treatment very well. I mean, other than fatigue. I had some random stuff that happened, but it wasn’t anything other than that first time getting sick, I never got sick again. It just made me super tired. I would sleep for 3 days straight and I was exhausted. 

Sammie became dehydrated post-chemo
Sammie became nauseous from chemo
Sammie felt fatigue from chemo

Honestly, I instantly started feeling better because I didn’t realize how sick I had been the whole year prior. Finally, my body was being treated for what it needed for so long. My weeks off of chemo, because I had 2 weeks in between each treatment, I felt so good. I had felt better than I had felt in a year.

What was your staging?
Sammie was stage 4

Lymphoma staging is a little bit different, and they explained this to me right when they told me my stage because I was stage 4. My oncologist explained that that doesn’t mean what it means for other cancers. Mine was on the lining of my lungs, which made it stage 4, but I didn’t have it in any of my organs. But lymphoma, no matter what stage it is, it’s just as treatable, just as curable.

Hair Loss

Sammie discusses hair loss from chemo
Hair loss was a difficult side effect of chemo
Sammie was in denial about losing her hair
Describe your experience with hair loss

One of the hardest side effects that I had was losing my hair. That wasn’t even something that had crossed my mind when I was sitting in the hospital because I had so much to think about, and losing my hair wasn’t on my priority list. When I finally asked my doctor, “Am I going to lose my hair, because I know everybody doesn’t lose their hair.” She said, “Yeah, you’re going to lose your hair.” I was in denial. 

I thought that that was the biggest deal of my life at the moment. Now, looking back, it was such a small part, but to me, it was so big. It was really, really traumatic to lose my hair. I eventually reached that point, like I think everybody does, it’s just time to shave your head because I was completely balding on my head. I waited a long time, but it started falling out about a week after my first treatment. I was shocked at how fast it was falling out. I chopped my hair pretty short so it wouldn’t be as dramatic. That was definitely the hardest side effect that I had experienced.

One of the hardest side effects that I had was losing my hair.

Trying on different wigs

We have a nonprofit organization close to my home that gives out wigs for cancer patients. I got a couple of wigs before shaving my head, which made me feel a lot better. I did not want to shave my head if I didn’t have a wig ready to go. 

Sammie tried on different wigs before shaving her head
Sammie received wigs through a nonprofit organization close to her home

Once I chopped my hair, my hair was falling out in clumps and I was getting to the point where I didn’t want to get my hair wet in the shower. It got to be so much that I had accepted it. It was fine. Me and my sister shaved my head and it was fun. We didn’t make it a sad thing. We made it the best that we could. Past that, I haven’t even been sad about my hair at all. Looking back at it, I’m like, it was so silly for me to be so devastated by it because I’m so lucky to still be here and have this life. Something like losing your hair, in the big picture, does not matter.

What advice do you have for someone experiencing hair loss?
Sammie encourages people to shave their head when they're ready

Shave your head when you are ready. If you’re good with it and you want to, you’re ready to shave your head, then do that. I had to do it when I was ready. I think that helped me get closure. I knew it was time. You will get to that point where you need to shave your head, versus in the beginning when I still had my hair and it wasn’t falling out yet. Don’t shave your head, just wait and get a short haircut. Then it’s not as drastic as a change for you. I think that helped me a lot.

Recurrence 

What did scans reveal during your cancer treatment? 

I got one scan in the middle of my treatment, which showed significant improvement in my mass that I had in my chest. Then I had one right after treatment. My follow up scan was February, so a couple months after. In the moment, it seemed like it was taking forever. Now looking back at it, it seemed like it went by so fast. 

Follow up scans showed her cancer was getting better
Sammie was anxious when getting scans because she wanted to know if treatments were working
Her last scan revealed her cancer was back

Halfway through my treatment when I got that scan, you could totally tell that it was so much better than what it was. It gave me so much hope and motivation that this is working. This is doing what it needs to be doing. It gave me more motivation to keep going. Because, in the back of my head, I’m going through this chemo and I’m like, what if this isn’t working? What if I’m doing this for nothing? When I would get those scans and they’d be good, it made me feel better. 

I got the last scan after I’d finished all my treatment and it looked way better than what it did, but it still wasn’t great. But they didn’t want to do any further treatment, so they said, “We’ll just scan again.” I think it was 3 months after, so that was February. I got another scan and that’s when it showed that my cancer was back. The same spot lit right back up.

What was the timeline between the end of your treatment and when you received that last scan?
Sammie finished chemo in October and had recurrence in February

I finished my chemo in October 15th, and then in December, I had 1 round of methotrexate. January was my second round of methotrexate and after that I was supposed to be completely done and it was supposed to take care of the cancer. Then in February, a month later after methotrexate, that showed that my cancer was back.

How did you process having recurrence?  

That was really, really hard. At that point, I was signed up to go get a new job. I was planning on going back to college. I had so much stuff lined up and I was so ready and excited to get my life back. Seeing that was just as bad as the first time, honestly. The first time getting diagnosed, it was like, okay, I’m going to do this. I can do this. I’m so strong. But the second time it was like, oh, I have to do this again. That was my mindset. I was not ready to go through that again. It sucked. It really sucked.

Sammie was ready to go back to college prior to recurrence

CAR T-Cell Therapy 

What was your next course of treatment? 

They again knew exactly what to do. We were going to do the CAR T therapy, which is an immunotherapy that basically uses your specially altered T cells which are part of your immune system to fight the cancer. They explained the whole process and how they take my T cells out, send them to California, they’d genetically modify them, and send them back to me. 

They started the process right away. They also started the stem cell transplant process, just in case it had to come to that. They started doing a bunch of blood tests and getting stuff ready just in case this CAR T therapy didn’t work. 

Everybody that I had talked to in the medical field, if they’d asked me what my plan was and I’d say CAR T therapy, they were all so impressed with this new treatment.

Sammie's next course of treatment was CAR T-cell therapy

At first it sounded super overwhelming, hearing that I had to do this transplant. I shouldn’t call it a transplant, but immunotherapy, and being in the hospital for 2 weeks. I couldn’t drive for 2 months. It sounded like so much. I had went from finally getting a break from being in the doctor’s office and getting my blood drawn to right back to where I was back in June. I had to go get my blood drawn every week. 

April 10th was when they started my CAR T therapy, and I was there for 2 weeks taking my cells out. It took about 6 hours, but putting them back in after they had came back took 12 minutes to do. It was very quick. I just sat in the hospital for 2 weeks and they monitored me very, very closely.

What did you know about CAR T-cell therapy?
Sammie didn't know much about CAR T therapy before receiving it
Sammie's oncologist explained CAR T is a new therapy that doesn't have much data
Doctors were excited to hear Sammie was opting for CAR T therapy

It was very crazy. I had never heard of that. Everybody that I had talked to in the medical field, if they’d asked me what my plan was and I’d say CAR T therapy, they were all so impressed with this new treatment. A lot of my oncologists explained it like, “This is going to be the new chemo that people use because it’s very effective and it’s way easier on people’s bodies than chemo. It’s still new, so there’s not a ton of data on that.” 

Instantly, I’m Googling, what is CAR T therapy? It’s crazy stuff. The machine that they hooked me up to, they had to put a line in my neck to get my cells out. It really is amazing what technology has come to and what it’s continuing to do.

Describe your experience getting CAR T therapy

The whole going through CAR T therapy was pretty easy. I don’t want to use the word easy, but there wasn’t a ton happening. The only thing that really sucked was you have to give CAR T therapy time for the cells to do what they’re supposed to be doing. It was a big waiting game to see if this transplant had even worked. That was the hardest part. I just wanted to know the 2 weeks that I was in the hospital. 

Sammie's experience with CAR T therapy was an easy one

They tell you that if you develop symptoms, it’s a good thing because it means that it’s doing something and it’s working, but I really wasn’t getting many symptoms, which freaked me out. I’m like, what if this isn’t working? I have no idea and the doctors can’t tell you if it is or not. There’s no way to tell. The waiting game was super hard. 

I got a scan a couple months after and it had showed good progress, but I still didn’t hear the word “remission” until July 20th, this last July. It took a while because I had my CAR T on April 10th and I didn’t hear remission until July, which isn’t that big of a difference. Those times, and especially those weeks waiting in the hospital sucked. I just wanted to know, is this working? Was this worth it? Looking back, it was worth it. But the waiting game was the hardest part.

Being monitored post-cancer

In July, I was told I was in remission. I get scans every 4 months. I had the PET scan in July, but now we’re doing CT scans from now on. I’m checking in with my doctor every few months to see how I’m feeling. They won’t order any more scans unless I give them a reason to and unless I’m not feeling good. 

Sammie was told she was in remission in July

My oncologist always warns me, “You know your body the best. If you don’t feel good or you feel like something’s off, please tell me.” That’s super important to remember, but also, I still don’t feel like this whole last year and a half was real. I don’t even feel like this happened. Being told I’m in remission is still so new to me. It feels really weird. I’m so thankful and grateful, but it’s just a lot to process.

Reflections

Do you feel like you’re still processing your cancer journey now?
Sammie is still processing her diagnosis to this day

I think so, because in the moment, I was fighting for my life. Now when I’m going back to college and right before college started, I’m freaking myself out. I’m like, what just happened last year? This doesn’t feel like it even happened. I do think that I spend a lot of time looking back at the last year and a half because my life changed so, so fast.

The importance of finding a cancer community

I don’t know anybody my age going through what I’ve gone through. I had a great support system with my friends and family, but I would highly recommend finding a community online, like through social media. I’ve met a lot of great girls my age that are going through what I’ve gone through. It was refreshing to hear people are going through what you’re going through. I have my friends and family here, but they can’t sympathize or know exactly what you’re going through unless they’ve gone through it themselves. It’s scary. 

Sammie emphasizes the importance of finding a cancer community

»MORE: Read More About Cancer Support

Finding people that you can talk to that have gone through it feels really good. That helped me a lot too. Even though I had so much support here, I think meeting people online too that were specifically my age made a big difference. 

It was super hard, when I got diagnosed last June and all my friends are starting to go back to college and I had just turned 21, so my friends are turning 21 and it was really hard. My friends are going out, going to college, graduating college, and I’m sitting there hooked up to chemotherapy. It sucked.

I would highly recommend finding a community online.

Did you preserve fertility?

I’m glad you brought that up because I did want to touch on that. When I had first got diagnosed and I’m sitting in the hospital, I had a ton of social workers and a lot of different groups and support systems come talk to me. One of the teams that came in was a fertility team. I had these 4 ladies come in and talk to me. At first I was like, that wasn’t even something that had crossed my mind. I was not even thinking of that. They gave me a little pamphlet of options that I could do. 

Sammie discusses preserving fertility
Sammie only had one option, to shut her ovaries down
Sammie was able to preserve fertility before treatment

Unfortunately, I could only pick one of the options because I needed to start chemo right away. Some women can freeze their eggs, they have time to, but I was diagnosed and instantly had to start treatment. I got a shot once a month that shut down all my ovaries. 

In the moment when they were explaining that to me, I started bawling. I remember specifically my oncologist said to me, “Samantha, this is scary, but it’s a good thing. We’re talking about you being able to have kids one day. Think of it that way, it’s good.” I’m like, “Yeah, you’re right. I’m going to be okay and I’ll be able to have my own babies one day.” But that wasn’t something that I had thought about. I think that is something that’s a big part of who we are too. That was super scary.

»MORE: Fertility After Cancer Diagnosis

Being a patient advocate 

I feel like I trust myself more than I did before. I listen to my body more and I stick up for how I feel.

Sammie is learning to trust herself

All my life, I had never really needed to go to the doctors. I had gone for maybe a yearly checkup, but I had always been so healthy, so I never really realized how big of an advocate you have to be for yourself. It’s kind of scary that you have to be an advocate for yourself. I wish that the doctors could just know, but obviously they don’t. They need a lot of data. They need symptoms, they need a lot of tests. Now I feel like I trust myself more than I did before. I listen to my body more and I stick up for how I feel.

What advice do you have for someone on a cancer journey?
Sammie encourages cancer patients to stay strong and fight

Stay strong and fight as hard as you can because it’s so, so worth it. Find a good support system and surround yourself with people who make you feel really good. Also, be your own advocate. You know your body better than anyone else, and if you think something is wrong with you, it probably is. So just trust it. Trust yourself.

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Categories
Avastin (bevacizumab) Chemotherapy Colon Colorectal FOLFOX (folinic acid, fluorouracil, oxaliplatin) Patient Stories Surgery Treatments Xeloda (capecitabine)

Keith’s Stage 4 Colorectal Cancer Story

Keith’s Stage 4 Colorectal Cancer Story

Shortly after gallbladder removal, Keith developed what felt like gallbladder pain. His wife encouraged him to go to the ER where he received a CT scan that revealed a mass in his colon. After removing the mass and some lymph nodes, a biopsy showed Keith had stage 4 colorectal cancer

As a husband and a father of two boys, Keith discusses the impact his diagnosis has had on his outlook and life and how he stopped working to prioritize time spent with his sons. 

Now on his third line of treatment, Keith discusses cancer support groups, chemotherapy,  treatment side effects, mental health, how he is considering a double lung transplant, the importance of being a patient advocate, and his advice for others on their own cancer journeys.

Keith shares about his colorectal cancer symptoms, treatment and diagnosis
  • Name: Keith H.
  • Diagnosis (DX):
    • Colorectal Cancer
  • Staging:
    • Stage 4
  • Symptoms: 
    • Abdominal pain
  • Age at DX: 41
  • Treatment:
    • Chemo
      • FOLFOX
      • Avastin
      • XELIRI
      • Vectibix 
    • Surgery
      • Tumor removal
      • Liver resection
Keith's colorectal cancer timeline

Don’t give up hope, number one. Absolutely educate yourself on your disease and be an advocate for yourself along with your care team.

Keith H.

This interview has been edited for clarity. This is not medical advice. Please consult with your healthcare provider for treatment decisions.


Colorectal Cancer Symptoms

Tell us about yourself

I’m Keith. I’m 43 years old. My hobby is that I love to be outside kayaking, hiking, and walking. I’m a Corvette enthusiast who’s working on my car and hanging out with my dogs. Those are usually the 2 that hang out with me while my kids are at school and one might poke his head in. He’s a very large Great Dane. My wife, kids, and I like to travel. We like to do a lot of international travel and domestic as well.

Keith experienced abdominal pain
Keith is on his third line of cancer treatment
Keith discusses his experience with colorectal cancer
When did your symptoms first occur? 

Early in the year 2021, I had my gallbladder removed. Then in May, I started to have abdominal pain again, very similar to when I had gallbladder issues. 

I was coaching Little League baseball the night of May 4th, 2021. As the night progressed, the abdominal pain continued to get a little worse, so much so that my wife forced me to the hospital in the middle of the night. 

Keith began experiencing abdominal pain
Getting emergency surgery 

I went to the emergency room, and they did a quick CT scan and found a mass in my colon. They did a couple of other tests like blood work and stuff, and they said that they were going to be prepping me for emergency surgery because they wanted to get that mass out. 

As they did more digging and research, they also found several lymph nodes that were impacted as well as 4 lesions on my liver at that time. So that’s a whirlwind of how we got started. 

I went through that emergency surgery that night and was in the hospital for about 11 days. A couple of days after my surgery, I became septic so I had a lot of issues health-wise. We weren’t sure how that was going to play out, but I was actually able to make it out of the hospital the day before my wedding anniversary, which was nice. I started chemo shortly thereafter.

Keith received emergency surgery which revealed a mass

I went to the emergency room, and they did a quick CT scan and found a mass in my colon.

Did you have other symptoms besides abdominal pain?

No, nothing. Even what would have been 6 months before that, I did a triathlon. No issues. I’m not necessarily saying I’m the most healthy person in the world, but I definitely didn’t consider myself unhealthy by any stretch of the imagination.

Besides abdominal pain, Keith didn't have other symptoms
Keith didn't consider himself unhealthy before his diagnosis
Keith had recently run a triathlon pre-diagnosis
What did doctors say about your minimal symptoms?

I was told that 41 was very young to be diagnosed with this. They mentioned that they’re seeing more and more of this in younger patients being diagnosed very late stage. Some of the traditional symptoms are rectal bleeding and abdominal discomfort. But for me, I really didn’t have any of that, other than the gallbladder pain that came back. 

I thought it was strange because you shouldn’t have pain in an organ that was removed. I thought initially it was maybe some type of surgery complication that turned out to not be a surgery complication at all. It was a whole other issue.

I was told that 41 was very young to be diagnosed with this. They mentioned that they’re seeing more and more of this in younger patients being diagnosed very late stage.

Doctors said Keith was young to be diagnosed with late stage colorectal cancer

Diagnosis & Treatment

What was your official diagnosis?

I was diagnosed with stage 4 colorectal cancer.

How did you react to your cancer diagnosis?

It was tough. I went to the hospital during COVID times, so nobody else could come with me. I went by myself. I was in the emergency room by myself and had to make a call to my wife that they found a mass. Even at that point, I still really didn’t comprehend or grasp what the situation was. I was thinking, okay, they found something, they got to get it out and then I can go home and move on with life. That wasn’t the case. 

It was very shocking initially and I was almost numb. It wasn’t until after the surgery when I started to recover in the hospital that my situation and the diagnosis became real. 

The more doctors that I spoke to while I was in the hospital didn’t necessarily paint a real great picture of the survivability, how long I would be around, and all those things. Luckily, I have a great oncologist I met several weeks after all that, which helped put things into perspective a little bit, and while obviously still serious, there’s at least hope.

Keith was diagnosed when COVID precautions were in place
Keith was initially shocked by his diagnosis and then numb
Doctors didn't paint a great picture of the survivability of Keith's cancer

I still really didn’t comprehend or grasp what the situation was. I was thinking, okay, they found something, they got to get it out and then I can go home and move on with life. That wasn’t the case.

What cancer treatment options were you given?

After surgery recovery, I met with my oncologist about 4 weeks after my initial diagnosis and surgery. We walked through traditional first-line chemotherapy FOLFOX, which is a pretty aggressive first-line treatment and pretty standard care for most of these patients. We did add Avastin into the mix as well to hit it harder, which is probably the best way to describe it. 

Keith's first chemotherapy was FOLFOX

We talked through side effects and what to expect over these 6 months. The intent was curative intent and to get me to a position where I could be surgical in regards to the liver situation. 

Undergoing liver surgery and chemo

We went through 4 months of FOLFOX before I was able to have my liver surgery. They did a liver resection in October of 2021 and took out about 30% of my liver. The good news is most of the lesions that were in the liver were necrotic. Chemotherapy, knock on wood, had done its job, and then I recovered from that surgery. 

They did ask me to complete 4 additional rounds of clean-up chemo just to make sure there wasn’t anything lingering out there that didn’t show up on scans. I left the hospital in October extremely excited. You get this diagnosis 4 months before and it’s a pretty dark picture, and to be told that we got it all? In my mind, I beat it and we’re moving on with life. We can go back to normal. 

About 2 months after that, a follow-up CT scan showed numerous spots in my lungs. It had hid for a little while and then metastasized further into the lungs which we’re still working on treating today.

Keith had a liver resection

About 2 months after that, a follow-up CT scan showed numerous spots in my lungs. It had hid for a little while and then metastasized further into the lungs which we’re still working on treating today.

Describe your side effects from chemotherapy
Keith had fatigue on chemo
Keith had nausea on chemo
Keith had a blood cot on chemo

Of all the chemo that I’ve been on, that first-line treatment was pretty rough. FOLFOX is not for the faint of heart. I had a lot of fatigue and nausea. At one point, I did have a blood clot that they deemed Avastin probably caused. That was a little scary. I had a blood clot that started in my leg and moved into my lungs. We were able to work through that and get that resolved.

Mental Health

The physical and mental toll of cancer
Keith sought professional help to assist with his anxiety

I did seek out some professional help from a therapist’s standpoint, and that helped me tremendously.

I looked at it as 2 things. There’s the physical piece – there’s a lot of medications and vitamin supplements and things like that I was taking to help. But I think the first year of this was more challenging on the mental side if I’m being honest. It was pretty dark for a while because the first thing most people do is grab their cell phone and computer and start searching for your disease and they want to learn more about it. 

The prognosis for stage 4 colon cancer patients is not really great. I’ve got 2 young boys and my wife, we have a great family. To think about losing all that in a very short window is very humbling. I went through a pretty dark depression phase where I lost hope. This was before treatment really started and things started to actually show some progress. 

»MORE: Cancer and Mental Health 

I did seek out some professional help from a therapist’s standpoint, and that helped me tremendously. Not only to be able to take the feelings that I’m having at different points throughout the day or the week or whatever and work through and process those but to get me centered and present instead of sheltering away.

Breaking the stigma of men expressing their emotions

I think that the traditional model of men don’t cry, keep your feelings in, walk it off, and rub some dirt on it is just culture. My wife and I had a lot of conversations about depression and the diagnosis. It’s great to be able to talk to friends and family, but there’s a note that a professional can bring to those conversations that friends and family can’t. 

Keith discusses breaking the stigma of men expressing their emotions
Keith encourages seeking professional therapy
Keith appreciates the support he's received from friends and family

Friends and family will tell you, “You got this, you’re going to be okay, we’re going to get through all those things,” and it’s all with good intentions. But the professional side will actually take you through how to deal with the dark stuff, how to work through those feelings, how to deal with anxiety, and how to deal with depression so you can actually enjoy life instead of just living secluded and isolated. 

I did find a couple of groups shortly after my diagnosis that really helped me with peer-to-peer, patient-to-patient, sharing stories, hope, avoiding isolation, and being able to talk to people who truly understood what I was going through.

Talking to children about a cancer diagnosis

Honestly, as a father, that was the hardest conversation I’ve ever had. My wife and I talked a lot about this before and what approach we wanted to take. At the time, 2.5 years ago, they would have been 9 and 11. You think 9 and 11-year-olds are pretty young, but kids are smart, especially with technology at their fingertips. They’re able to find the answers if you don’t provide them, so we made the decision that we were going to be age-appropriate, open, and honest with my diagnosis, my condition, and how life is going to look for a while. 

»MORE: How to Talk to Kids About Cancer

I look back on that and I’m really glad we made that decision because I’ve met other folks that are going through similar things that chose a different option. Every family is different and everybody’s decision on how they include their family in these conversations is something very personal. But I’ve also seen a lot of family and friends be torn apart simply because they felt things were hidden from them.

We made the decision that we were going to be age-appropriate, open, and honest with my diagnosis, my condition, and how life is going to look for a while.

Keith talked to his children about his cancer diagnosis

I wanted that to be the voice, I wanted them to feel like they’re a part of this story and what we’re going through, and not dismissed. Even 2.5 years into this, I still double down and think that was the right decision for us. 

Having a support system

As for my parents and in-laws, we needed a lot of help right in the beginning. This was right at the beginning of summer break when all this happened. My kids are extremely active in sports and activities. Being out of the mix for a while, recovering from surgery, we needed a lot of help shuttling kids here and there and just dealing with life. It doesn’t stop just because somebody gets sick. 

We were able to have a lot of conversations and tough conversations, but at the same time, as family does, there’s a lot of hope, positivity, and support that comes with those conversations.

Keith discusses having a cancer support system

Metastasis

Blood work is pretty traditional and then we also used ctDNA testing to monitor residual disease and that’s actually what gave us the smoke alarm…It posted positive.

How long after your diagnosis did you learn your cancer metastasized? 
A Signatera test revealed cancer was present

About 2 months. It would have been January or February 2022 till March or April that I didn’t have residual disease and nothing showed up on the scans. Then we started using a couple of different tools to monitor my disease. Blood work is pretty traditional and then we also used ctDNA testing to monitor residual disease and that’s actually what gave us the smoke alarm. It was a test called Signatera, which is a molecular test for ctDNA. It posted positive. 

How did you react to your cancer recurrence? 

It sparked a flurry of emotions and feelings that it’s back. Because of that positive test, my medical team ordered scans and so forth. At first, nothing showed up, so we were at this weird place where we knew something was there. We know something’s brewing, but we just can’t see it and we don’t know where it is. 

Keith discusses undergoing recurrence
What treatment did you opt for with your recurrence? 

I’m really lucky in regard to the medical team that I have. My oncologist and I walked through different options. We could do nothing and wait to see what pops up and deal with it then. Or, what is not very common, is my oncologist actually offered me to go ahead and start back on treatment again knowing that something’s there, it’s going to show up, we just don’t know when. While chemotherapy is not fun, we opted to go ahead and start treatment to be as aggressive as we possibly could. About a month after that, they did a follow-up CT and then found 14 spots on both sides of my lungs.

Keith underwent chemo after recurrence
A follow-up scan revealed he had 14 spots on his lungs
Not knowing where the recurrence was at first, was chemotherapy the right choice? 

I think if anything, it bought me time to process and plan with my team what approach we wanted to take. The treatment that I started then would have been the treatment that I would have started if we waited regardless. I know there’s no real way of knowing, but in my heart, I believe it probably saved it from popping up in other places as well. While 14 spots in your lungs are not great, it could have been worse. I think that some of those tools that we’ve used put us in a position to get ahead of it to try to treat it the best we could.

Keith believes the chemo was able to prevent cancer from spreading
What chemo were you on post-recurrence? 

I know there’s no real way of knowing, but in my heart, I believe it probably saved it from popping up in other places as well.

My second line treatment was called XELIRI, which is Xeloda Irinotecan, and then we kept Avastin in the mix as well. I was on that cocktail for about a year and a half.

»MORE: Chemotherapy FAQs & Patient Stories

Keith was on XELIRI chemo
Keith kept Avastin in the mix of his chemo treatment
Did you experience side effects on this chemo?

There were side effects, so still some fatigue and some nausea, but the ability to bounce back was so much faster. When I was on my first-line treatment with Folfox, after that infusion, I would be out of commission for 4 or 5 days in a row and miserable. The worst flu possible is the best way to describe it. 

Keith discusses side effects on his current cancer treatment

Then when I moved to the second-line treatment, the day after infusion was pretty rough. Then you started to come out of it pretty quickly and that cycle was every 3 weeks. I actually got an extra week of good feeling into that mix too. While again, no chemo is great, it definitely was good from a quality-of-life perspective.

Staying on a curative path

We had that tougher conversation around curative intent versus palliative care, and I’m still on a curative path. I’m not ready to succumb to this is going to be my life forever. I know that seems kind of silly at times, but I think for me mentally, I need to know that curative is still a path. 

Keith expresses that cancer stability is positive

I’ve also learned I have to accept stability as positive.

Hearing that was obviously frustrating, it was discouraging. But I feel like we were in the right place to get started when we did. As I said, that cocktail worked for about a year and a half. 

What we started to see, and this was just a couple of months ago was that some of those numbers like my Signatera test started to increase, but my scans still showed stability. Again, maybe I’m an oddball, but we’re in this weird situation where we know the chemo that I’m on wasn’t reducing anymore, but it was keeping things stable. I’ve also learned I have to accept stability as positive. 

But we had that conversation around if this drug is no longer shrinking but is holding it stable, is it best to stay on this until it stops working altogether or do we want to go ahead and fast forward a little bit and jump on third-line treatment? The path that we’ve always taken is the most aggressive path and the best probable outcome. We made the decision to go ahead and jump ship and start third-line treatment, which started about a month and a half ago.

What cancer treatment are you on currently?

The third line for me is Vectibix, which is an EGFR inhibitor along with Irinotecan. So one of the old drugs and one of the new drugs and that’s where this lovely rash comes from, is from the Vectibix.

How long will you be on your current treatment? 

The good news is that I have found options post this line of treatment. Exiting standard of care, there are a couple of clinical trials that I’ve already looked into and tentatively been approved for.

Keith is considering a double lung transplant

Until it stops working. I love being the oddball. All the spots in my lungs are very small and they’re all under a centimeter. So for me to get into any clinical trials, I don’t qualify because they’re not big enough to biopsy. I’m in that weird situation of, you almost want it to grow to be able to qualify for trials and things like that. But mentally, I just can’t accept that. I’m just going to continue to beat it down until I can’t beat it down anymore, so it’s indefinite right now. 

The good news is that I have found options post this line of treatment. Exiting standard of care, there are a couple of clinical trials that I’ve already looked into and tentatively been approved for. It’s a pretty aggressive opportunity that’s being tested in an NCI center close to me, it’s a double lung transplant for metastatic cancer patients. That tumor board has already approved me, but I have to exhaust the traditional standard of care, which is the current treatment that I’m on now.

Reflections

There are plenty more options out there as long as you’re willing to do the research and find them and go wherever it takes to get whatever that treatment may be.

The importance of being a patient advocate

I don’t want to take anything away from my team because they are great, but at the same time, there’s a realization that you’re not their only patient. They’re not going to invest 40 hours a week looking into different options for you. 

Keith encourages cancer patients to advocate of themselves

I’ve learned a lot through a couple of advocacy groups that I’m a part of that have really helped me understand the value of second opinions. For me, second, third, fourth, fifth, sixth, and seventh opinions. I’ve traveled quite a bit to get a better understanding of options that are out there and things that are at different cancer centers I can’t get locally. That has helped me open up some doors and continue to build that hope strategy around, there’s something else after this instead of just saying, this is the last standard of care line. This is it. 

There are plenty more options out there as long as you’re willing to do the research and find them and go wherever it takes to get whatever that treatment may be.

Doing your own research to understand your options

I think a big misunderstanding, and it is not the fault of your local oncologists and teams, I think it’s just how the systems are built. You have to be a component of your care and you have to be an advocate of your care. That also comes with education. I had this misunderstanding that I would just go to my oncologist and they would take care of everything and they would prescribe, “Here’s what you need to do to get rid of X, Y, and Z,” and then things would be great. 

I can’t stress enough, exhaust your options in regard to opinions. There are never too many opinions and too many places to visit to get ideas.

Keith encourages people to do their own research

There are limitations to every cancer center that’s out there. Some specialize in the cancer you have and some don’t. For me, knowing that I’m not going to get a list of trials that are across the United States for me to look into. They provide some that they’re familiar with, but ultimately, a lot of that research lies on the patient along with opinions. I can’t stress enough, exhaust your options in regard to opinions. There are never too many opinions and too many places to visit to get ideas.

How often are your scans?

Because I’m still on active treatment, I see my local team every 2 weeks and we complete scans every 3 months. My next scan will probably be at the end of September. That’ll be the first true telltale sign of how this new line is actually working. My hope is it can get me to a point where surgery would be an option from a lung standpoint, but it’s got to do some good work.

Keith sees his team every two weeks
Keith receives cancer scans every 3 months
Keith hopes chemo will improve the spots on his lung

I will say that the positive is that, I just had my third, but after 2 rounds of this, one of the tumor markers in my blood is the second lowest it’s ever been. I’m hoping that correlates in September to good news on a scan, but we’ll see when we get there.

Do you experience scanxiety? 
Keith expects bad news when he gets scans so that he isn't disappointed

Let yourself be surprised when there’s good news and actually enjoy that.

It was a lot worse in the beginning than it is now, but don’t get me wrong, there’s still scanxiety. I think My Chart is a blessing and a curse at times because you have access to those scans as soon as they’re available. Sometimes I see them before my oncologist. When it’s a good scan, that’s great, because then you can high 5 and move on about the day. It’s when it’s not that the panic sets in – do I need to call, when are they going to see it, what’s our next step? 

»MORE: Coping With Scanxiety: Advice From Cancer Patients

How I’ve learned to deal with it is you just have to accept it. That sounds really weird, but you have to accept the situation you’re in. You’re going to get good news and you’re going to get bad news, and more than likely, you’re going to get bad news more than good news. With that mindset, you’re not expecting to go in and everything’s going to be great and the scans are going to be clear.

Don’t set yourself up for something that’s not realistic. It helps a ton. Let yourself be surprised when there’s good news and actually enjoy that. When it’s not, learning how to process that, going back to see a professional that can help with tools and tips and tricks to work through some of those things has helped me post-scan to be able to control some of those things.

Do you still work?

I stopped working after my diagnosis. We were lucky enough to be in a situation where I could step away from work and we could live our lives as normally as we had. I know that is not the situation for a lot of folks, so I don’t take that lightly. 

What it has allowed me to do is spend my time how I want to spend it and prioritize my time differently than I did in the past. I think with a lot of folks, work is always this big rock that you always have to spend time on. Then, you get home and you got kid’s activities and all these different things. It just consumes the day. With me not having to work, I’ve been able to spend time with my kids that I never would have had the ability to do. 

Keith stopped working following his diagnosis
Keith spent the past two summers doing whatever his sons wanted to do
Keith is able to spend his time the way he chooses

One of the things that I’m most grateful for is the last 2 summers, our kids would go to some type of camp or care when I was working. But since I’ve been home, we didn’t have to do that. I was able to stay with the boys both summers and they coined the term Summer of Dad. What they would do is they would take a plain old calendar, and just start filling it with all these activities that they would want to do throughout the summer break. My job was to find ways to get all those things to happen over the course of 65 days or 80 days or whatever it is. 

It has been so much fun and so rewarding to spend that time with my kids. My phone’s not ringing. I don’t have to worry about email. I don’t have to worry about the grind of a traditional job. I’m able to spend my time how I want.

Which cancer support groups do you recommend?
Keith advocates for COLONTOWN cancer group

I would be remiss if I didn’t mention a couple of groups that helped me tremendously through this diagnosis. One of those is colon cancer-specific. It’s a group called ColonTown, a nonprofit organization that focuses on patient and caregiver-led support, education, and being able to, share stories and speak to people who are going through things that you’re actually going through. 

The other group would be Man Up To Cancer. This is an all-cancer type group, but specifically for men. We touched a little bit earlier on that stigma of male mental health, isolation, and those types of things. That group is phenomenal at helping solve that gap and really providing support and help for men specifically to not isolate during these times and how critical it is to not do that. 

Keith recommends Man Up To Cancer cancer group

As a cancer patient being able to find the people who are going through this with you, it’s amazing. The connections you can make with people, whether it be online or in-person, that are going through things. It’s almost a bond that’s stronger than any relationship I’ve had with people I’ve known for years. I don’t know if it’s a trauma response or what it is, but it’s interesting to be able to surround yourself with like-minded people in similar situations. You just feel that weight gets taken off your shoulders to some extent when you can share and know that people get it.

What advice do you have for others on a cancer journey?
Keith encourages cancer patients to not give up hope

Don’t give up hope, number one. Absolutely educate yourself on your disease and be an advocate for yourself along with your care team. Be a part of those conversations. Don’t just let those conversations be done to you and take your life back. 

To say I’m not scared of death is an extreme understatement. I’m actually terrified of that, but can’t control when that’s going to happen. It’s all in science’s hands at this point. What I don’t want to do if I get to that point, is look back and say I’ve wasted the last year, 2 years, 3 years, whatever that is, worrying and not living my life. That will be my biggest regret as a father, a husband, and just as a human. 

Everybody has a stopwatch above their head, and some might be shorter than others, but I’m going to maximize every day I can and I’m going to do whatever I can to enjoy it, whether that be enjoying my own hobbies or spending time with my friends and family. I’m not going to let it take that part of my life away.

More Colorectal Cancer Stories

 

Shannon M., Colon Cancer, Stage 1




Cancer Details:
Found the cancer as a result of her Lynch Syndrome
1st Symptoms: Routine colonoscopy found polyp
Treatment: Partial colectomy

Hugo T., Colon Cancer, Stage 1



Cancer Details: Diagnosed 2 weeks after 5 years remission from testicular cancer
1st Symptoms: Inflamed bowel
Treatment: Subtotal colectomy, immunotherapy

Rachel B., Sigmoid Colon Cancer, Stage 1



Cancer Details: The sigmoid colon (or pelvic colon) is the part of the large intestine that is closest to the rectum
1st Symptoms: Stomach discomfort, nausea, bloating, blood in stool
Treatment: Colectomy

Chris T., Colon Cancer, Stage 2



Cancer Details: Discovered Lynch Syndrome after genetic testing
1st Symptoms: Found the cancer as a result of family history, early colonoscopy
Treatment: Partial colectomy

Shannon C., Colon Cancer, Stage 2A



Cancer Details: Diagnosed at 29, tested positive for Lynch Syndrome
1st Symptoms: Severe pains after eating
Treatment: Partial colectomy
Barbara smiling

Barbara M., Colon Cancer, Stage 3



Cancer Details: Family history wasn’t flagged, should have had colonoscopy earlier
1st Symptoms: Stomach discomfort, difficult to process food
Treatment: Colectomy, Chemo (FOLFOX, CAPOX)

Shelley B., Colon Cancer, Stage 3B



Cancer Details: Had no usual first symptoms, found as a result of routine colonoscopy and endoscopy
1st Symptoms: None
Treatment:Partial colectomy, chemotherapy (FOLFOX)
Lindsay

Lindsay D., Colon Cancer, Stage 4



Cancer Details: Diagnosed at 32, cancer spread to ovary and lung
1st Symptoms: Lump in pelvic area, funny-smelling food, weight loss
Treatment: Chemotherapy, colectomy (surgery)
Lee

Lee J., Colon Cancer, Stage 4, Recurrence



Cancer Details: Recurrence then remission
1st Symptoms: Discovered stage 4 cancer from unrelated CT scan
Treatment: Neoadjuvant chemo (FOLFOX), hemicolectomy (partial colon surgery), adjuvant chemo (FOLFOX), chemo post-recurrence (FOLFIRI), liver surgery

JJ S., Colorectal Cancer, Stage 4



Age at Diagnosis: 27l



1st Symptoms: Abdominal pain, blood in stool



Treatment: Surgery to remove tumor, chemotherapy, clinical trial of Keytruda (pembrolizumab)
Haley P. feature profile

Haley P., Colon Cancer, Stage 3C



Symptoms: Constipation, fatigue, shortness of breath
Treatment: Surgery, chemotherapy
Amanda G. feature profile

Amanda G., Colon Cancer, Stage 2A



Symptoms: Gurgly stomach, blood in stool, chronic constipation
Treatment: Surgery (hemicolectomy), chemotherapy (CAPOX), Zarxio
Jason Randall describes his colon cancer journey
Jason R., Colorectal Cancer, Stage 4 Diagnosis: Colorectal Cancer Symptoms: Abdominal pain, constipation, belly button discharge Treatment: Liver surgery, chemotherapy, radiation
Angelica A., Bowel Cancer, Stage 3

Symptoms: Fatigue, anemia, irregular bowel movements, loss of appetite, heavy periods Treatment: Laparoscopy, chemotherapy, partial hysterectomy
Danielle shares her stage 4 metastatic colon cancer
Danielle A., Colorectal Cancer, Metastatic Stage 3 Diagnosis: Stage 3 Colorectal Cancer Symptoms: Abdominal pain, constipationTreatment: Surgery, Chemo
Keith shares his stage 4 colorectal cancer story
Keith H., Colorectal Cancer, Stage 4 Diagnosis: Stage 4 Colorectal Cancer Symptoms: Abdominal painTreatment: Surgery, Chemo
Sherrie shares her stage 4 metastatic breast cancer story
Sherri O., Metastatic Breast Cancer & Colon Cancer Diagnosis: Colon & Metastatic Breast Cancer Symptoms: Shortness of breath, lump under armpit, not feeling herself Treatment: Chemotherapy, Transfusions
Dania M.

Dania M., Colon Cancer, Stage 4, with Liver and Peritoneal Carcinomatosis



Symptoms: Constipation, diarrhea, terrible bloating, swollen belly, as if pregnant
Treatment: Surgery, immunotherapy (KEYTRUDA)
Stephanie K.

Stephanie K., Colon Cancer, Stage 3



Symptoms: Very bad cramps, bloating, indigestion, burping
Treatment: Surgery, chemotherapy (CAPOX)
Jason A. feature profile

Jason A., Colon Cancer, Stage 3B



Symptoms: Abdominal pressure, fatigue, small amounts of blood in stool
Treatment: Surgery (colon resection), chemotherapy (FOLFOX: folinic acid, fluorouracil, and oxaliplatin)
Kelly shares her cancer story
Kelly B. Diagnosis: Stage 3 Colon CancerSymptoms: Blood in stool, cramping, bloating Treatment: Chemo, surgery
Courtney shares her colorectal cancer story
Courtney H. Diagnosis: Stage 1 Colorectal CancerSymptoms: Blood in stool, fatigue Treatment: Chemo, oxaliplatin, capecitabine, surgery
Zykeisha shares her stage 4 colon cancer story
Zykeisha L. Diagnosis: Stage 4 Colon CancerSymptoms: Anemia, stool changes, blood in urine, back painTreatment: Chemo, Avastin, FOLFOX, FOLFIRI, surgery, Neupogen shots
Categories
Chronic Lymphocytic Leukemia Obinutuzumab Patient Stories self-advocacy Venetoclax

Susan’s Chronic Lymphocytic Leukemia (CLL) Story

Susan’s Chronic Lymphocytic Leukemia (CLL) Story

Susan K. feature profile

Susan was diagnosed with chronic lymphocytic leukemia (CLL) with 13q deletion in 2019. She noticed a lymph node on her neck one day and was initially brushed off as just having a virus or allergies.

A few months down the line, a closer look at her blood work revealed some significant irregularities in her numbers, which ultimately led to the CLL diagnosis.

She emphasizes how being an informed patient is so important. She knows how essential it was to understand her disease and have the knowledge. More importantly, she stresses how important it is to find a CLL specialist.

In addition to Susan’s narrative, The Patient Story offers a diverse collection of CLL stories. These empowering stories provide real-life experiences, valuable insights, and perspectives on symptoms, diagnosis, and treatment options for cancer.


  • Name: Susan K.
  • Diagnosis:
    • Chronic Lymphocytic Leukemia (CLL)
  • Initial Symptoms:
    • Swollen lymph nodes on the neck
    • High white blood count
  • Treatment:
    • Venetoclax & obinutuzumab
Susan K. timeline


Introduction

I live in the greater Boston area, about 25 miles north of Boston. I’m married with two children of my own and I have two step-kids. My daughter has a baby. My granddaughter’s three and a half. She’s the love of my life.

I’m the founder of a nonprofit. I used to be a social worker. I ran a program for low-income folks to help them out of poverty. I did that for 25 years. I was also a wardrobe stylist at the time. I put them together and started a nonprofit that empowers women through fashion and it’s called The Midlife Fashionista.

I’m also a style and beauty influencer for women over 50. I blog and I do my photos.

I’m still involved in Uncommon Threads so I have a pretty full life.

I also co-founded Kicking Cancer in Heels with Michele Nadeem-Baker, who I’m sure everyone knows.

Susan K.
Susan K.

Pre-diagnosis

Initial symptoms

I’ve been a very healthy person my whole life. I rarely got sick.

I did have some low-level fatigue for as long as I can remember. I never felt like I could keep up in sports. I always felt a little achy and tired. But other than that, no health issues.

In the summer of 2018, I was feeling the back of my neck and noticed a lump. I went to the walk-in center and they said, “You must be fighting a virus. A lot of people get swollen lymph nodes. It’s really nothing.”

It happened again. I noticed another one pop up. I went to my doctor and she said, “You probably have allergies.” I did so I didn’t think anything of it.

I went to my GYN for some menopause blood work. She called me and said, “Your white count is extremely high. You need to see your primary.”

I went to my primary right away and they were very concerned. They did CAT scans and ended up sending me to a hematologist. My numbers were not normal, my lymph nodes were not normal. That was the beginning.

It was really important for me to do the research and to see someone who lived and breathed CLL, who did the research, and who was developing some of the drugs and the trials. It was really important that I saw that top person who really knew everything about CLL.

Finding out about the abnormal blood tests results

There’s always a zillion questions that go through your mind. Is it cancer or is it something else? What’s going on with me? My brain always goes to the worst-case scenario. I was definitely afraid.

When I heard that I had CLL, I actually knew what it was. I have a very close friend who was diagnosed about 10 years prior. I had been through the journey with her and I knew what it was when I finally got my diagnosis.

Finding the right medical team

I started with a local hematologist. She was good, but I decided I wanted to be in Boston.

I ended up with a general hematologist who specialized in CLL at Massachusetts General Hospital and from there, I ended up at Dana-Farber with Dr. Matt Davids, who only sees patients with CLL.

It was really important for me to do the research and to see someone who lived and breathed CLL, who did the research, and who was developing some of the drugs and the trials. It was really important that I saw that top person who really knew everything about CLL.

Susan K.
Susan K.
The difference with seeing a CLL specialist

I started locally at an offshoot of Dana-Farber in my area, but it’s just not the same. They’re very good, but they’re just not as specialized.

Dana-Farber did far more tests than they did locally. They dug deeper. They looked more at the markers and the prognosis indicators. There’s a huge difference.

Finding out the results of the scans

It was crazy because I’d gone for the scans then my daughter and I were sent to Florida. We were the faces of the Soma Intimates Mother’s Day campaign.

I knew there was something really serious. I didn’t know exactly that it was cancer, but I had a feeling. It was really scary. It interfered with my having a good time down there. I was really trying my best, but in the back of my mind, I thought, I’ve got to get home. I’ve got to call specialists, I’ve got to get on this.

It was probably a month. I had that little bit of a delay for 3 or 4 days while I was away and I couldn’t really do anything. Then I ended up seeing somebody right after.

Diagnosis

Reaction to the diagnosis

I was diagnosed in January 2019. The doctor said, “You have CLL. It’s very rare. You probably have never heard of it.” I said, “Yes, I’ve heard of it. My friend has it.” I knew a lot about it.

My friend was doing very well at the time. She had gone a number of years without treatment. She was in watch and wait so it felt good knowing that she wasn’t in treatment and she was doing so well.

But I always thought it was so strange because how could you walk around with cancer and not be treated? How does that work? Isn’t that kind of scary and weird?

I also think that my great-aunt probably had CLL. She had long, chronic leukemia and ended up dying of a heart condition when she was in her late 70s. She was diagnosed with leukemia for a long time. I’m not sure exactly if it was CLL, but I have a really good suspicion it was just because it was so long and chronic.

Susan K.

Find your tribe. Find your family. It can be friends, can be neighbors. Find people who can support you.

Susan K.
Family processing the cancer diagnosis

They’re unbelievable. I have not one complaint. They have been so supportive, so incredible.

My husband comes with me to every appointment. My kids have done their research. They’ve looked up CLL. My son has come with me to appointments during COVID.

Everyone was so careful. They were living life extra protectively just for me, wearing masks everywhere.

Even now, they will tell me who they’ve been with, and what they’ve done, and let me make the decision if I think it’s safe for me to be with them without a mask. They just couldn’t have been better.

Whether you have a family locally or you don’t have a family that is supportive, find your tribe. Find your family. It can be friends, can be neighbors. Find people who can support you.

Treatment

Discussing treatment options with the medical team

Everybody reassured me that I may never even need treatment. My markers were really good. I was feeling good. I wasn’t getting chronic infections. They kind of instilled that message into me that it’s going to be a very long time. “You may not even need it. Many people don’t even need treatment.”

Unfortunately, my numbers rapidly increased. I started at around 20,000 or maybe a little bit more than that when I first got diagnosed. Five years later, I was at 347,000. My white count number was multiplying much faster than the doctors had expected.

We could see it over the years when they graphed it out. There was a pattern. It was going up pretty quickly. I would need treatment probably within five years and they were totally right. Totally accurate.

Susan K.
Susan K.
Watch and wait

In the beginning, I threw myself into seeing holistic doctors. I even went up to Montreal, Canada, to be seen by one of the world-renowned holistic doctors. I was determined I was going to beat it with a good diet, exercise, mindfulness, and everything that’s good for you.

It didn’t make any difference. I wasted an awful lot of money.

I’m not saying that it’s not a good thing to do because living healthy is good. But what I’ve learned is that for CLL, it’s a different beast. It’s blood cancer. It’s very different than solid tumors.

Everything that I was doing did nothing. I put a lot of time, a lot of energy, and a lot of money into trying all these different things that really weren’t effective.

At some point, I just said, “You know what? I’m just going to enjoy myself. I’m tired of saying, ‘I’m not going to have that piece of cake. I’m not eating any sugar or I’m not going to eat any meat.’” I did change and went more toward moderation.

Exercise is important. I do a lot of walking. I’ve tried to reduce stress. I’m a very anxious person and I carry stress in my stomach, my back, and my neck. I really tried to find ways whether it was taking a really brisk walk or sitting down to clear my mind and listening to some calming music just to ground myself and calm myself down.

Stress is really tough on our bodies. Forget not eating Twizzlers. I think trying to manage stress is probably even more important.

Watch and wait is a strange beast. You’re walking around with cancer not knowing if you’re getting treatment or not or if it’s tomorrow or next year.

Susan K.
Susan K.
Nearing treatment time

The last year before treatment, I was definitely starting to feel a little more fatigued. On certain days, it wasn’t holding me back from doing anything.

But about two months before I started treatment, I began to have daily fevers. At 3 o’clock, 4 o’clock in the afternoon, like clockwork, I would start to chill and my temp would go up to 100°F, 100.5°F. I’d take acetaminophen and within three hours, it was gone.

It was the weirdest thing. But that was an indicator that I was going to need treatment.

My numbers were climbing, my platelets were dropping, and my hemoglobin was dropping.

Treatment getting pushed back due to infection

The treatment was scheduled for September 2022. Right before treatment, I wanted to be with my family normally.

We had dinner on my daughter’s porch. I wore a mask and thought, Boy, I’m going to be extra careful and I’m going to wear my mask with everyone because COVID and getting sick is not a good thing if you’re going to start treatment.

Then I just said, “Oh, forget it. You know what? This is my last opportunity to kiss my granddaughter’s face and her neck and squish her tight,” so I did.

The next day, she came down with a bad cold. We all got it, but I got it worse, of course. I got a very bad sinus infection that lasted for a month. During that time, I was really sick. I needed to start in September, not October so it pushed things off a bit, which was unfortunate.

Susan K.
generic pill bottle
Treatment plan

Because of my markers, the doctors agreed that I should be on a fixed-duration treatment. I had already researched the options and talked to my doctor about the options. It was venetoclax and obinutuzumab.

However, at the point when I needed treatment, a new trial came out with one arm of venetoclax and obinutuzumab and I think the other arm was venetoclax and acalabrutinib. It was figuring out which is the best option through the trial.

But because I didn’t know which arm I was going to get and I had already made up my mind that I wanted venetoclax and obinutuzumab, that’s what I stuck with. And I think it was a good choice.

Ramp-up dosing

With this combination, you start with obinutuzumab, which is an infusion. Before the venetoclax was introduced, I think it was about a month.

For obinutuzumab, they start at a low level then they go up very slowly until they reach the full dose. It can take quite a while to get to your full dose. There’s a lot of hospital time involved.

I had to go home with an IV in my arm, come back the next day fighting 7 a.m. traffic for 2 1/2 hours, get blood work done, and then if you’re okay, you can be sent home.

They introduce venetoclax at some point then they do the same thing. You have to ramp up slowly.

I had to be in the hospital for a full day. Sometimes it was a 12-hour day. They do blood work. They give you the venetoclax and you can’t go home until they know you’re doing okay, you don’t have any severe reactions, and then they ramp that up.

Susan K.
Susan K.

Once you’re completely ramped up, it’s less time. For me, the worst thing was the fevers for sure. The other tough part of it was just so much time in the hospital, but, hey, a small price to pay.

Side effects of venetoclax & obinutuzumab

There was some fatigue that went along with that. The worst thing that happened to me was it killed off so many cancer cells all at once. I went from 347,000 white blood cells down to 4,000 in 48 hours. It was crazy.

I did have a reaction. I started with uncontrollable fevers every day where I was shaking, like convulsive fevers. I’ve never had anything like it in my life. They’d start at the end of the day.

When you have a fever and you’re on treatment, you absolutely need to be seen because you can be neutropenic, you can have all kinds of serious issues going on, and infection.

The medication worked too well. It was actually a good thing. Even though it’s so scary and it’s not what you want, this is good. Your body’s reacting. It’s killing off cancer cells.

Dana-Farber was closed. I would have to go to the ER. We went to the ER three or four times. It was really tough. You’re so worried about COVID.

On one of my visits, they really needed to keep me overnight, but the ER doctor talked to Dr. Davids and they both agreed it was actually too risky. My numbers were so bad that the risk of infection in a hospital was worse than just going home and coming to Dana-Farber the next morning for a shot of pegfilgrastim.

I got through that. That was a few weeks of hell, I won’t lie. But after that, I did really well.

They introduced the venetoclax and a lot of GI issues are associated with it. I had none.

My infusions ended in March and I’m on venetoclax till the end of November. Hopefully, I can be off of everything and go into remission.

The medication worked too well. It was actually a good thing. Even though it’s so scary and it’s not what you want, this is good. Your body’s reacting. It’s killing off cancer cells.

Susan K.
Susan K.
Follow-up scans & appointments

I go to Dana-Farber every two months for blood work. I don’t know if I’m in remission. I don’t know how long it will be. They haven’t told me yet — could be six months, could be four months.

I’m getting there. I’m seeing the light at the end of the tunnel. Two months is very manageable right now.

Your medical team’s role in your care

Right now, it’s just my CLL specialist. However, there are other cancers that are associated with CLL because it affects your immune system, which weakens your body, and melanoma is one of them so they have me see a specialized dermatologist who deals with cancer. She knows everything about CLL. She is incredible. I’ve got this other set of eyes watching skin changes.

There are skin reactions that a lot of patients get on some of these medications. One of my friends had a reaction. Her local dermatologist thought it was eczema or psoriasis or something and treated it. It was, in fact, the wrong treatment because it was related to the drug that she was on.

I’m really lucky. Forget two hours of traffic. I’m so lucky that I live near some of the best care in the world.

When you’re with someone who is a specialist, you get that top level of care. It’s really important.

Importance of communication between your doctors

Things like having your records sent over from other doctors and encouraging your doctor to speak with your team so that everyone is on the same page. Those are really important things.

Even when I have a mammogram, I have my results sent to Dana-Farber. I have them sent to my primary so that everybody is on the same page and everyone has all of the records and knows.

The importance of seeing a CLL specialist

My doctor’s in the labs. He’s working on trials and doing research. When you’re with someone who is a specialist, you get that top level of care. It’s really important.

two people talking
blood tests

Important CLL markers

These markers are prognostic indicators, kind of a roadmap of what your disease might look like. What types of treatment might be more effective? If you’re at higher risk, then they would like to see. It’s really an assessment.

Thank goodness we have these tests available because they really help the doctors navigate. I have 13q deletion. No one wants to have any markers, but it’s not the worst one to have. I’m mutated, which is a very good thing.

Then I have something which is very unknown. In CLL, they look for NOTCH1, which is a very bad marker. You don’t want to have NOTCH1. I have it, but it’s not specific to my cancer cells.

The doctors said, “Don’t worry about it. Think about it as a weed. You pull it out. You don’t know if it’s a good weed. You don’t know if it’s a bad weed. It’s so rare. We really have no idea. But don’t lose sleep over it because we just don’t know.”

The markers have been really important for me as my treatment plan is being put into place. They were able to figure out what the best course of action was for me.

Reaching remission

They know it’s working. My numbers are really good. I won’t know until probably late November if I’m in full remission, which would be amazing.

If I am, I’ll be going off of everything and I’ll hopefully be good for five-plus years. That’s what the research is showing. There’s an 85% chance of that, which is good.

Even though I’m 61, I’m considered younger so I think that’s in my favor, too. I don’t have other conditions, which is a good thing.

If there are some cancer cells left, then I still will go off of the treatment, but it will be more like going back to watch and wait again. I’ll be monitored more closely. I’m shooting for remission.

Susan K.
heart cloud

Hopeful for new CLL treatments

There are so many trials going on. There’s so much research going on. There are new drugs coming through all the time.

My doctors basically said, “Let’s get you into a long remission. Who knows, right? By then there could be a cure. We don’t know.”

I’m very hopeful. We’ve made huge breakthroughs in cancer treatments and research. I’m not going to be a glass half-empty. I’m going to be a glass half-full.

Advocacy work

Michele Nadeem-Baker and I met virtually during COVID. I joined a support group that she was running. I learned she lives 30 miles from me and she’s my age. It was amazing to find someone younger to connect with.

We put our heads together. The first thing we did was start a virtual support group called CLL Women Strong for women who are living full lives with CLL. We have an incredible group of women from all over the country.

We want to take things a step further and tap into her background in communications and journalism and my background in social work, fashion, and beauty. We put it all together and started Kicking Cancer in Heels, which is an online community for women who are impacted by all kinds of cancer to bring hope, inspiration, and resources.

We do interviews and Instagram Lives on everything from women who have started businesses during their cancer journey to makeup tips and a little bit of fashion to stress management. We share some stories, too.

It’s become this incredible community. We offer it to everyone, whether you have cancer or not, but also to people who might have someone in their lives, a woman in their lives with cancer. It’s really all-encompassing.

Susan Kanoff and Michele Nadeem-Baker
Susan K.

Words of advice

Do your research. Find a really good doctor. If you can’t find a CLL specialist in your area, find a top hematologist who works with a lot of CLL patients. Ask that hematologist: out of your practice, what percentage of patients are CLL?

Find your community. Write down your questions, be your own advocate, and be knowledgeable. Knowledge is power.

Some of our support group members actually come to Boston once a year from out of state so they can get another opinion and speak to one of the top CLL specialists. If there’s a large city around you with a specialist, perhaps it is worth driving to once a year and just doing virtual appointments in between.

Have your doctors communicate. I can’t recommend enough finding a specialist so if you can’t find one, at least connect with one. Have them on board for you.

Being careful, especially during COVID

It’s tough. The world has gone on. Everyone’s sick of COVID. Unfortunately, COVID is still around. It’s not sick of us.

It does present challenges for the immunocompromised population like me. I have opened up my life a little bit. I’ll do outdoor dining. I’ll see friends outside.

We had a gala for Uncommon Threads. I haven’t been to our gala in years. This is the program I started so it’s really important for me to be there.

I took a chance and went, much to my doctor’s dismay. He was not happy with me, but I wore a good mask. I had to take it off when I spoke. I was determined that people were not going to hug me. But of course, everybody hugged me. I just said, “You know what? It is what it is. Hopefully, I’m going to be okay.”

There are so many challenges, even in hospitals. Dana-Farber just removed the mask mandate. A friend of mine who was in treatment at Dana-Farber before COVID says no one wore masks. That was the way it was. That was normal.

I will wear a mask when I’m in a store, in a crowd, and in a hospital. Hopefully, it’s protective. That’s all I can hope for. It’s not just for COVID. It’s for RSV, flu, everything.

Susan K.

I flew to Florida right at the very beginning when we heard that COVID was probably coming our way. I flew down and we didn’t have masks. We were so busy wiping the seats down with disinfectant, which did nothing because it was airborne.

I was very lucky. All of us were very lucky that we came back without getting sick because as soon as we got back, all hell broke loose. It was all over the news. 

I’ve been lucky I’ve not had COVID yet and I hope to keep it that way, but the odds are not in my favor. Most people have had it already.

During treatment, I can’t get another vaccine so I haven’t been boosted. It’s not going to do anything for me during treatment so my doctor said, “Don’t even bother. It’s just not going to be effective. You might as well just not have it right now.” I have to walk around like I’m unprotected.

Tips on finding the right specialist

There are so many good websites out there. CLL Society gives a list of doctors who specialize in CLL. Do your research. It’s really important.

To me, it was crucial that I was with someone who was an expert in the field who wasn’t dealing with 20 other blood cancers but only focused on CLL. Everyone’s different, of course, but it was very important to me.

Get on Google. It’s a wonderful thing. It can be a bad thing, too, but there is a lot of information out there.

Get a second opinion. I feel like it gives you a point of comparison. Interview your doctors. Find out who you’re most comfortable with, who really has the knowledge and expertise that aligns with your disease.

If you can’t do that, if you don’t have a specialist in your area, then do telehealth. If you even have to travel and you can travel, visit a specialist so that you get that other opinion. It’s so important.

note taking
Take down notes

I use the Notes app on my phone. When I think of a question, I write it down so it’s a running list. So many times you think of a question then you forget it later.

As you go through your cancer journey, keep jotting down those questions so that when you do go to the doctor, you have them readily available.

Some people keep a notebook. That’s fine, too. I find my phone is just the easiest for me. I can check them off as I get them answered and put the answers there.

Keep yourself informed

There are so many questions that are important to ask your doctor. You want to know about drugs. You want to know about interactions. You want to know about treatment options. You want to know about watch and wait and what that means.

How should I be living right now? Are there activities that I should be avoiding, foods that I should be avoiding, or foods that I should be eating? You could have a list of 100 questions, which I did.

I actually went to many cancer websites and got some really, really good lists of questions then I added to it. The more informed you are, the more research you do, the more knowledgeable you are, then the more powerful you are as your own advocate.

Being your own advocate is so important. You can catch mistakes, too. Doctors are human. Medical staff are human. Mistakes do happen. Sometimes, you might catch something just because you know what that term means what that blood test means, or what that medication interaction is. Do your homework.

When you’re diagnosed with any kind of cancer, let yourself feel. You are not going crazy with this tsunami of feelings. It’s just all these feelings rushing in. You’re angry, you’re mad, you’re sad, you’re grieving, you’re questioning. Did I do something to cause this? Let yourself feel, but don’t stay stuck in it because it is not going to be helpful to rehash all the stuff all over again.

Don’t let cancer run your life. I have cancer. I am not cancer. It is not my identity and I can still be happy and live a full life with cancer. It’s really important. I think it can be depressing to know that you have something very serious.

woman on laptop
Susan K.
Don’t get stuck in the cancer diagnosis

I have to push myself. To be honest, I can get really stuck in it. My husband calls me a glass half-empty and sometimes I can be so I really have to work hard.

Self-talk is so important. Do things that make you happy. Exercise. Be with your community whether it’s over Zoom or it’s in person.

It’s so important to have friends and family who are supportive of you. Keep them close and tap into your resources. You really want to have that person to call when you’re feeling lousy and have them talk you off the cliff.

Live your life

Don’t let cancer run your life. Understand your disease, but live, too.

Even though I couldn’t go to big weddings or big parties, we found ways to have fun and bring joy to our lives. My husband’s a trooper because he’s doing the same thing that I’m doing to protect myself.

We recently went to Vermont. My daughter has a vacation house there. We invited friends. Four days before, they were really careful. They wore masks everywhere. Everyone tested prior. We ate outdoors and we had a blast.

Get creative and try to find ways to bring joy to your life and happiness because life is short for all of us. No one knows what the next five seconds are going to bring so just live your life and enjoy your life.

The more we connect, the less alone we feel. It’s really important.

Susan K.

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Categories
ABVD Bone marrow transplant Cancers Chemotherapy Classical Hodgkin Lymphoma Immunotherapy Patient Stories Treatments

Danielle’s Stage 1 Classical Hodgkin’s Lymphoma Story

Danielle’s Stage 1 Classical Hodgkin’s Lymphoma Story

Being a health-focused family, Danielle and her family were shocked to discover Danielle’s mother had a rare blood cancer known as myelofibrosis. To get a stem cell transplant, her mother needed a donor, and tests showed Danielle was a good match. Danielle needed an x-ray to confirm she was healthy enough to be a donor. The x-ray revealed a large tumor in her chest, catalyzing her own journey with cancer. She was diagnosed with stage 1 classical Hodgkin’s lymphoma

After landing her dream and preparing to step into a new career, at 25, Danielle wasn’t ready to be held back from beginning her life. Still, she found herself adjusting plans to account for various cancer treatments, resulting side effects, and a cancer recurrence. 

A month in remission, Danielle shares her cancer story with us including her experience with chemo, fertility preservation, and a bone marrow transplant, her plans of turning her journals into a book, her outlook on being diagnosed with Hodgkin’s lymphoma twice, and her advice to those on their own cancer journeys.

Danielle shares her Hodgkin lymphoma treatments, staging and diagnosis
Danielle's classical Hodgkin lymphoma timeline

I feel like even when you’re struggling, you can reach for the stars and find meaning in your suffering, never give up hope, and always choose love over fear.

Danielle D.

This interview has been edited for clarity. This is not medical advice. Please consult with your healthcare provider for treatment decisions.


Diagnosis

Tell us about yourself

I’m Danielle Draper. I’m 26 years old. I was born and raised in Annapolis, Maryland but I’ve been living and working in Washington, D.C. for the last four-ish years. I really like politics and government affairs. 

For fun, I love hanging out with a really large friend group and normal mid-twenties activities. Going out to concerts. I’m really adventurous, I love to travel, and I love yoga. I really want to be a yoga teacher. I grew up doing dance my whole life. I’m really into health, fitness, exercising, and eating healthy. My family and I have always been really into integrative health.

Where did your cancer journey begin?
Danielle's mother was diagnosed with myelofibrosis

She had a rare blood cancer called myelofibrosis, which is a malignant bone marrow disorder. She was diagnosed with cancer.

My story is extremely unique in that my mom started feeling really itchy and would bruise easily, but she was just going to her normal physical doctor’s appointment and she got her blood drawn as usual. She’s a super healthy person, and all of a sudden, her platelet count was extremely low. 

She bounced around a few doctors, then finally, one doctor was like, “I think you should get a bone marrow biopsy.” That confirmed that she had a rare blood cancer called myelofibrosis, which is a malignant bone marrow disorder. She was diagnosed with cancer.

The “C” word was never in our vocabulary. My family is so healthy, so that was such a shock for my family. Especially when the doctor told my mom, “You’re going to have to get a stem cell transplant.” We’ve never heard that word, so we were like, all right, what is the stem cell transplant? It’s a very intense procedure where they would replace her unhealthy blood cells with healthy cells using a donor. Most hospitals try to get a family member to be their donor because they’re most likely a good match. They requested that I get tested because I’m her daughter. I’m also young and healthy. 

Preparing to donate stem cells for a transplant

We got tested and I found out I was a pretty good match. We started the approval process right away. There were a lot of questionnaires, I was going to get a lot of blood tests and everything was getting approved and was looking really good. At this point, we had told all our family and friends this is what’s happening. We gathered such a huge support system. Everyone was encouraging me and my mom that our family was going to get through this. 

Danielle prepared to donate stem cells to her mom

Now we’re about 3 weeks away from my mom’s transplant, everything’s going in order, and the date had been decided. A few weeks before, they had to do final approval tests which included a physical exam by the donor because they wanted to make sure that the donor was perfectly healthy. 

I went to the hospital and I did an EKG, a blood test, a physical exam, and a chest x-ray. I definitely wasn’t worried. I rarely went to the doctor for anything at that point in my life. I didn’t even have a primary care doctor, just my pediatrician from my childhood. I went in with a very positive attitude, I felt fine that day, everything was looking good and I was just bouncing around.

A chest x-ray led to a surprise discovery

The doctor walked in and she asked me to sit down and she was like, “We found a tumor in your chest near your heart.”

A chest x-ray revealed a tumor in Danielle's chest

I got the chest x-ray and the nurse said, “Oh, don’t worry, we’ve never had a donor have a problem.” Those were famous last words. I was waiting in the hospital room for over an hour, like, wow, these results for the chest x-ray are taking a really long time. I still didn’t think anything of it. I just thought hospitals were slow. 

Then the doctor walked in and she asked me to sit down and she was like, “We found a tumor in your chest near your heart.” They were just as surprised as I was. Everyone was like, wait, what? She said, “Have you been losing weight?” I said, “Actually, I have been losing weight a little bit.” But I had started really exercising that fall, I’d been eating healthy. I thought it was just me making better, healthy choices in my life. She said, “If you’re losing weight, that’s obviously not a very good sign.”

Did you have any symptoms?
Danielle had no symptoms prior to her cancer diagnosis

This is definitely a unique situation where I felt fine, but there was a mass the size of my fist near my heart. I didn’t know anything about oncology or anything. My mom went to her doctor and was like, “This is what’s happening.” Then my doctor sent me to one of the best oncologists in Annapolis. I feel really blessed. It was almost like a recommendation by word of mouth. 

Getting a biopsy and diagnosis 

He said it was classical Hodgkin’s lymphoma.

We went to the oncologist and he took some blood labs and already things were not looking very good because Hodgkin’s lymphoma has certain markers and tests you can do. Those weren’t very good. He asked to get a biopsy right after Christmas. 

Danielle was diagnosed with classical Hodgkin's lymphoma

I tried to have a normal Christmas. December 27th at 5:00 in the morning, I had the biopsy and I think my oncologist pulled a few strings to rush the results, but we got the results the next day. He said it was classical Hodgkin’s lymphoma, one of the most common cancers in people in their 20s. That terrible day of that chest x-ray was December 18th and then I was diagnosed December 28th, so in about 10 days I went from living a completely normal life to having cancer.

How did you react to your cancer diagnosis?

It was so shocking. I don’t even know how to describe it. It was definitely the worst moment of my life. I literally thought I was going to die the next day. I was like, I have a month to live. 

When I got that chest x-ray, my mom was traveling. She’s a flight attendant, and I called her because she had known that I was getting my approval test, so she was anxious to hear how it all went. At that point, everything was being approved. I called her and she was like, “Hi, honey, I’m about to take off.” She was traveling to Rome and she said, “Is everything all right? How did the test go?” I was like, I can’t tell her. I can’t ruin her trip, so I just lied and said, “Everything’s fine. I’ll see you when you get home.” 

Danielle discusses how she reacted to her diagnosis

Then I had to sit her down and I was like, “I can’t be your donor anymore.” She was like, “What? Why?” I said, “There’s a tumor in my chest.” It was probably the worst look on her face I’ve ever seen. I’ll definitely never forget that moment. It all happened so fast. It was so unbelievable. 

»MORE: How To Tell Your Family and Friends You Have Cancer

Chemotherapy

Were you working at the time of your diagnosis? 

A week before that, I had just gotten my dream job. I had been applying for 5 months, working the full-time grind of sending out resumes and cover letters and interviewing, and on December 10th, landed my dream job. I’m over the moon at that point. I had just moved into a brand new apartment with my boyfriend. I thought I was entering a new phase of my life. 

Danielle had recently gotten her dream job before her diagnosis
Danielle had recently moved in with her boyfriend before her diagnosis

That was my main concern, which is weird. It should have been will I die or not, but I was like, I want to start this job…When you’re 25 and just starting to enter the workforce, you don’t want to be held back.

Then when I got diagnosed, I think my first concern, which sounds silly, was I better not lose this new job because it’s something I’ve worked so hard on. That was my first question to my oncologist, can I keep working? Can I start this job? He was like, “If you think you can do it, I encourage you to do it.” That was my main concern, which is weird. It should have been will I die or not, but I was like, I want to start this job. 

»MORE: Working During Cancer Treatment

When you’re 25 and just starting to enter the workforce, you don’t want to be held back. But we were all really surprised. We barely told anyone because everyone was so worried about my mom. It was just so surreal that we didn’t want to tell anyone about what was going on with me because it was too much to handle.

Beginning cancer treatment
Danielle's doctor wanted her to begin cancer treatment immediately

Once I was diagnosed, 2 weeks later, [my doctor] was like, “Let’s get you started ASAP.” We did talk about fertility preservation. My oncologist’s niece was a fertility specialist. I guess they knew that I didn’t need as much treatment as someone who had stage 4 Hodgkin’s lymphoma. We decided to just push on. I really trusted him and his niece. They were like, “We believe you’re going to be fine.” I was like, okay, I trust you. 

I needed to get a port in, which I still have, and we started chemotherapy in the middle of January.

Did you opt for fertility preservation? 

It was so blurry because everything was moving so fast. When he was reading the list of side effects, which is pages and pages of side effects, fertility came up, which for a young person, is such an important part of your life. Me and my mom were like, “Do you think we should do this?” And he was like, “It’s really up to you. A lot of women do, but a lot of women don’t. I personally think you’re going to be fine.” He was very correct, I was fine.

Danielle discusses fertility preservation after cancer diagnosis
Did you have side effects from chemotherapy

I did, which is totally standard for Hodgkin’s lymphoma. I did 8 rounds. The standard is usually 12, but I did 8. It was terrible. I read somewhere that ABVD is one of the hardest regimens there is in chemotherapy. It is just so brutal. It’s this wave of toxic poison rushing throughout your body. I feel like a lot of cancer survivors talk about when you’re in that fight or flight. You’re so zoned in on making it through that. I made it through it. I slept. 

The first 4 days are the hardest, and you just sleep a ton and take it easy. I did a lot of yoga to manage my side effects, which is good for nausea, the digestive system and also managing anxiety. I also took Compazine, which is an anti-nausea drug. I definitely recommend asking your doctor for anti-nausea medication, being near a bathroom at all points, and trying to eat as much as you can. I also ate marijuana edibles which were approved by my doctor. And trying to go for walks, that’s how I manage the side effects.

Danielle had a difficult time on ABVD chemo

I read somewhere that ABVD is one of the hardest regimens there is in chemotherapy. It is just so brutal. It’s this wave of toxic poison rushing throughout your body.

How did your cancer react to chemotherapy? 

I did 4 infusions and then [my doctor] wanted to check if it was working. I got a PET scan that showed that I had a complete response. The tumor in my chest had disappeared completely, so we were so happy. 

A lot of doctors recommend that you keep going with more infusions, that way you’re killing off those hidden cells because PET scans don’t necessarily catch everything, unfortunately. His recommendation was to keep going, which was a little disappointing to hear because chemotherapy is so terrible. I hadn’t lost my hair yet. I was one of the few that didn’t, and I was like, I really want to hold on to my hair. But I trusted him, so I was like, alright, I’m going to put my head down and do 4 more treatments.

Danielle discusses side effects of chemotherapy
Did you lose your hair to chemo?

I lost it later, but during that point, I had really long hair and it definitely started thinning a lot, but it wasn’t coming out in clumps like a lot of survivors say. I had this feeling I could hold on to as much as I could. It’s super depressing. I loved my long hair and it started coming out. You always worry you’re going to wake up one day and look in the mirror and it’s just going to be gone. Preparing yourself for that, it’s traumatizing.

»MORE: Hair Loss and Regrowth After Chemotherapy

I forget what chemotherapy caused it, but it’s basically the chemotherapy they used to kill off my immune system before the transplant. It’s not even to kill the cancer. It’s to kill my immune system. They told me right away that it would pretty much remove all my body hair.

I loved my long hair and it started coming out. You always worry you’re going to wake up one day and look in the mirror and it’s just going to be gone.

Danielle discusses hair loss after cancer
Did you have a reaction to Bleomycin? 

No, I know that some people take off the Bleomycin because they’re getting really severe side effects. He was like, “We’re not seeing that, so I’m sorry, we’re going to keep going with it.”

Danielle was on Bleomycin
Reoccurrence
What were the results of your post-chemo PET scan?

I’d finished the 8th infusion. I rang the bell. My whole family came into the infusion center and were hysterically crying. It was a really happy moment. But of course, it’s not over till it’s over. I needed to get a clear scan so I could move on with my life, hopefully. They always encourage you to wait a month for your last infusion because they want the chemotherapy to settle into your body. 

I got a follow-up PET scan and he informed me that it had gotten bigger. That’s when it’s no questions asked. This is cancer, this is not a cold.

Danielle's scan post-chemo showed she still had cancer

It was about a month after my last infusion, we got a PET scan. I went in with really high hopes because I had already been in remission at that point. He told me that something was lighting up like a tiny, tiny little spot. The problem with Hodgkin’s lymphoma is that your lymph system is extremely sensitive. Like when you get a cut, a lymph node can swell up. When you have a cold, your lymph system can react. I had my COVID vaccine and that showed up on my PET scan once. The scans also can show how – they call it – hot like radioactive the lymph node is. It was very hot, very red, so that was not good. 

We entered a wait-and-see period over that summer. I got a follow-up PET scan and he informed me that it had gotten bigger. That’s when it’s no questions asked. This is cancer, this is not a cold.

Processing cancer reoccurrence 

I found meaning in my first diagnosis because we accidentally got that chest x-ray and it almost felt like a divine intervention. Everyone told my family how lucky we were. I didn’t have any symptoms and we just got that chest x-ray and I was stage 1, so we caught it extremely early. Many people are bounced around doctors for years. I felt like it was meant to be that I got that chest x-ray and found meaning in it and strength and hope and life lessons. 

With the second diagnosis, I was like, this is so unfair. I already went through this. I already gained the lessons that I needed to gain. I had already put in all the inner work. I was already committed to living a much healthier lifestyle. It just felt so unfair. I think that’s what I really got from my second diagnosis was, cancer is genuinely so unfair and random. It’s not because you ate fruit without washing it or you smoked a cigarette once in your life. No, it’s just incredibly random. No one deserves this. I think that’s what helped me process it, recognizing this wasn’t fair. I don’t deserve this. I didn’t do anything to deserve this. 

Danielle discusses cancer recurrence

I went to my new oncologist because I was referred to Johns Hopkins, which is one of the best medical schools in the country. Your first question is, did I do anything? Why did this happen? Almost 95% of Hodgkin’s lymphoma patients are cured for the first line of treatment. Why am I in the 5%? What did I do? He was like, “That’s pretty much the first question everybody asks. And it’s not because you didn’t pray hard enough or because you ate too much sugar or you’re not positive, but it’s just an aggressive form of Hodgkin’s lymphoma that’s resistant to chemotherapy. It’s not your fault, and there’s pretty much nothing you could have done to change it.” I told myself, it’s not my fault and I was dealt a crappy hand and was going to do the best I could to fight it.

With the second diagnosis, I was like, this is so unfair. I already went through this. I already gained the lessons that I needed to gain.

Switching medical care teams

My doctor told me that when you have refractory Hodgkin’s lymphoma, the next line of treatment is pretty much always a stem cell transplant, which is the same procedure my mom got when this whole thing started. That was a full-circle moment for my family.

He was like, “I’m recommending you see 2 doctors and decide which one you like better,” which I think is really important because I went to the first one and I was like, alright, I guess I could do this. We felt like we had made a decision. Then we went to Hopkins and we left there being like, whoa. We should go there. I feel like you should definitely have a second opinion. You never know which one will feel right in your heart. 

Danielle switched medical care teams with her recurrence
Choosing between a stem cell transplant and a bone marrow transplant

One hospital said they wanted to do an automated stem cell transplant, which is very common for relapsed Hodgkin’s lymphoma patients. Then we went to Hopkins and they said they wanted to do a bone marrow transplant which uses a donor similar to my mom’s transplant. I have a wonderful, young, healthy brother who doesn’t have a tumor in his chest. He was like, “We would love to use him as your donor.” 

Danielle considered a stem cell transplant and bone marrow transplant

They also did an outpatient program at Hopkins, and that changed my decision so fast. Not staying in the hospital was key to me. That scared me so much to see myself living in a hospital for a few weeks. It’s actually becoming more common around the country, these outpatient programs for stem cell transplant patients. They had an outpatient program, so I was like, I think we should go with Hopkins. I had the insurance approve it all.

Bone Marrow Transplant
Describe what a bone marrow transplant involves
Danielle discusses her bone marrow transplant recovery

It is a very long recovery where you’re extremely immunocompromised. You can’t leave your house for a few weeks.

A bone marrow transplant is a very intense procedure where they kill off my entire immune system, and then they transfuse my donor – which was my brother’s healthy stem cells – into my body. It’s this big bag. It pretty much looks like a bag of blood, but it’s surgically removed from my brother’s hip bone. He was placed under anesthesia and they extracted his bone marrow, put it in a bag, filtered it, and then brought it to me. 

At this point, my immune system is totally killed off through chemotherapy. I have no immune system, no white blood cells, and they infuse his stem cells into my body, and from there, it’s like a garden. He said, “Your immune system will start growing from scratch using your donor’s immune system.” 

It is a very long recovery where you’re extremely immunocompromised. You can’t leave your house for a few weeks. You’re extremely tired because you don’t have any white blood cells and barely any red blood cells, which is where your energy comes from. You’re super tired and there’s a load of other side effects, like you’re not hungry at all. You lose your hair immediately. There’s a lot of medication. For young adults, you definitely want to do fertility preservation before your transplant. Luckily, I had done that through Shady Grove before my transplant.

Preserving fertility 

That process went really well. I had a really good experience. Once you tell Shady Grove that you are an oncology patient, they put you on a fast track which they don’t do for normal people who are seeking fertility preservation. They know that you’re in a life-and-death situation. They want to get the process going as soon as possible so you can begin treatment. 

Also, there are so many programs out there that will pay for the medicine so you save thousands and thousands of dollars, which would otherwise be a really expensive process. I’m not saying it’s free by any means. It definitely is still pretty expensive, especially for a young adult like me. It’s why I started a Go-Fund-Me to help pay for fertility preservation. 

Luckily, it went really, really well. We extracted a lot of eggs. My oncologist was right about the chemotherapy not affecting my fertility. That made me happy that he was right because I still had a lot of eggs and the process went really well. I also feel like they showed me a lot of empathy. They knew that I was in a terrible position and time in my life. I also felt like the doctor showed me a ton of empathy whenever he saw me.

Danielle preserved her fertility before her bone marrow transplant

»MORE: Fertility After Cancer Diagnosis

Did you go through immunotherapy? 

I did have a few rounds of immunotherapy, which is pretty revolutionary in the cancer world. I can’t even imagine what the next 10 years are going to look like for Hodgkin’s lymphoma patients because immunotherapy has proven to be so successful with Hodgkin’s lymphoma. 

I had nivolumab and brentuximab and it got me back into complete remission before my transplant, which increased the success of the transplant tremendously. I was so happy to hear that the cancer was responsive. The side effects were night and day compared to the chemotherapy and you don’t lose your hair. I can’t wait to see what is achieved with immunotherapy in the next few years.

I can’t even imagine what the next 10 years are going to look like for Hodgkin’s lymphoma patients because immunotherapy has proven to be so successful with Hodgkin’s lymphoma.

Danielle discusses immunotherapy
What was your experience getting a bone marrow transplant like?

The bone marrow transplant process, it’s extensive. So much approval has to go into it because it’s an insane scientific achievement. I don’t even know the science behind it all, but so much approval goes into it. I’m getting my blood drawn all the time, my brother has to submit his blood all the time, making sure we’re both ready to do this thing. Getting my heart checked, lungs checked, making sure my liver is healthy, making sure everything is good. I had to get a sinus x-ray. A lot goes into the preliminary testing. 

Danielle discusses her experience with bone marrow transplant

Then finally it’s the extraction day, which they call your birthday. My birthday is April 4th, 2023. Right now, I’m like 5 months old. It’s a very exciting day. It’s actually kind of anticlimactic. I didn’t really feel any different when I got his bag of cells injected into my body. It’s like a normal blood transfusion. I was an outpatient, so I had to be monitored at the hospital every day for 60 days. The first month, they start giving you days off. That was nice. It’s not every day for 60 days, but almost every other day. 

What was recovering from your bone marrow transplant like?

My recovery was nothing short of a miracle in terms of side effects. I blame some of it on how terrible ABVD was, in that my pain tolerance was so high because of how terrible that chemotherapy was. By the time the bone marrow came around, I was like, this is terrible but not much more terrible than chemotherapy. 

Danielle documented her journey with Hodgkin's lymphoma

I pretty much did all the same way of treating the transplant side effects with my chemotherapy. I was sleeping a ton, trying to go for walks as much as I could, trying to eat as much as I could, and taking marijuana edibles. Then the mental side effects and being really transparent with my family and friends, and trying to have a strong network. 

I documented my recovery via TikTok. I started a TikTok for my cancer recovery and bone marrow transplant, process, healing journey. I did a lot of yoga during that time as well. I didn’t do it for very long, but even if you do it for 10 or 15 minutes, and not even extensively, you’re going to feel a little bit better each time and maintain your strength. That’s how I helped myself during that hard time.

What effect did the bone marrow transplant have on your cancer? 

The next day, I happened to be checking my email and I saw an email from my doctor that said the scan was all clear and have a great summer.

A hundred days after a stem cell transplant is when you get your follow-up PET scan to see if the transplant worked. We went back to Hopkins. Anyone who has ever had a scan knows the scanxiety that goes along with getting a scan. It is absolutely the worst feeling in the world. This mental anguish that goes with that waiting is so awful. It feels like you’re waiting to hear if you won the lottery of life or not. I barely slept at all. 

Danielle's bone marrow transplant was successful
Danielle experienced scanxiety before her PET scan
Danielle has been in remission for a month

The next day, I happened to be checking my email and I saw an email from my doctor that said the scan was all clear and have a great summer. Very anticlimactic, but I was so ecstatic. My mom, who was just as anxious as me, was driving to my apartment to be there when my doctor called me with the results. I decided to surprise her and record her reaction. We were super overjoyed knowing that it had worked, and now we can actually start the post-cancer follow-up journey. Because at that point, I had never gotten that far. 

Reflections
How does it feel to be in remission? 

You just start going back to your normal life but with this whole new outlook. You’re so grateful to be here and you appreciate the little things.

It’s so early. I just got into remission a month ago. My oncologist was like, “We’ll see you in September.” From there, we’re going to work out how often I should get a scan and blood tests. It’s early, so I think it will feel super real this winter because I’ve spent the last 2 birthdays and Christmases of my life with cancer. It’s really the fall and the winter that have been absolutely terrible. I think when that time comes and I don’t have cancer, it will feel actually real.

Cancer has given Danielle a new outlook
Danielle will see her doctor again in September
Danielle will celebrate her first birthday and Christmas cancer-free

You just start going back to your normal life but with this whole new outlook. You’re so grateful to be here and you appreciate the little things, as cliche as that sounds. Even getting dinner with my friends, I feel so grateful because about 2 months ago, I couldn’t even do that. I couldn’t go to a restaurant. Or traveling, I’ve been on so many trips this summer because I want to make up for lost time. 

I definitely have a ton of anxiety which I take medication for. I also go to a therapist and I do a lot of yoga. Definitely trying to have healthy outlets. I read a lot of books from cancer survivors. It helps me justify what I went through. Also social media. There’s a huge community on social media, so I feel like being there for each other is really important.

What would you say to someone on their cancer journey?

Cancer, and life in general, can be really unfair and you can be dealt a really bad hand that you don’t deserve. That said, the human spirit is remarkably resilient. I feel like since the start of humankind, we’ve all had faith. It’s within our DNA to fight and push on and do the best that you can with what you’re given. 

This tattoo says “Per Aspera Ad Astra.” It’s Latin for “through adversity to the stars.” I feel like even when you’re struggling, you can reach for the stars and find meaning in your suffering, never give up hope, and always choose love over fear.

Danielle shares her advice for those with cancer

When I was first diagnosed, I was pen to paper. I’m a huge believer in having a journal. I wrote so much that I want to turn into a book specifically for young adult patients. Because I feel like people in their 20s with cancer are a forgotten part of the cancer community because we don’t identify as children anymore, but we don’t identify as older adults. I definitely think it presents unique challenges that I want to write about and help others go through it.

More Hodgkin’s Lymphoma Stories


Madi J., Hodgkin's, Stage 1B



Cancer details: Most common and most treatable form of Hodgkin lymphoma
1st Symptoms:
Shortness of breath
Treatment:
3 rounds (6 infusions) of ABVD chemo

Danielle D., Hodgkin's, Stage 2



Cancer details: Diagnosed at age 25
1st Symptoms: Swollen lump on right side of neck/chest area, continued to grow
Treatment: ABVD chemotherapy (3 cycles = 6 infusions)

Lani S., Hodgkin's, Stage 2



Cancer details: Tumor pressing on heart
1st Symptoms: Appendicitis led to CT scan that found tumor
Treatment: ABVD chemotherapy, 7 cycles
Jason

Jason F., Hodgkin's, Stage 2A



Cancer details: Diagnosed at 39
1st Symptoms: Itchy legs, bloated face and “upper trunk,” slow-healing wounds, asthma worsened
Treatment: 6 cycles (12 infusion) ABVD chemo, 18 radiation therapy sessions
Logan

Logan A., Hodgkin's, Stage 2A



Cancer details: Diagnosed at age 15
1st Symptoms:
Lump in neck & fatigue
Treatment:
4 cycles of ABVE-PC chemo

Helicon K., Hodgkin's, Stage 2A



Cancer details: Found lymphoma cells in adenoid tissue
1st Symptoms: Difficulty breathing with blockage in nose, surgery to remove tissue resulted in discovery of Hodgkin lymphoma cells
Treatment: ABVD chemotherapy (4 cycles), radiation (20 sessions)
Lauren

Lauren C., Hodgkin's, Stage 2A



Cancer details: Diagnosed at 23 years old with nodular sclerosis, relapsed after 6 months of 1st-line treatment
1st Symptoms: Itchy body, enlarged lymph node over collar bone
Treatment: ABVD chemotherapy and ICE, radiation, and stem cell transplant for relapse
Wade looking out over a lawn

Wade W., Hodgkin's, Stage 2A



Cancer details: Diagnosed at 18 years old
1st Symptoms: Enlarged lymph nodes (around neck), diagnosed at 18 years old
Treatment: ABVD chemotherapy (2 cycles), AVD chemotherapy (4 cycles)

Moe C., Hodgkin's, 2B, Relapse



Cancer details: Diagnosed at 19, relapsed before remission
1st Symptoms: Fatigue, weight loss, night sweats
Treatment: ABVD chemo, DHAP chemo, MINE-R chemo, splenectomy, autologous bone marrow transplant
Fabiola

Fabiola L., Hodgkin's, Stage 2BX



Cancer details: Stage 2 with bulky disease, relapsed after 1st chemo. Remission after 2nd chemo & bone marrow transplant
1st Symptoms: Shortness of breath, dry cough, fatigue
Treatment: ABVD chemo (6 cycles), IGEV chemo, bone marrow transplant, BEAM chemo, brentuximab
Stephanie

Stephanie O., Hodgkin's, Stage 2B



Cancer details: Stage 2 with bulky disease
1st Symptoms: Shortness of breath, dry cough
Treatment: Stanford V chemotherapy (12 weeks, 1 infusion each week), radiation (20 days)

Chelsea B., Hodgkin's, Stage 2B



Cancer details: Diagnosed at 32
1st Symptoms: Lump in neck
Treatment: ABVD chemotherapy

Katee P., Hodgkin, Stage 2B



Cancer details: Accidentally found in x-ray after months of symptoms
1st Symptoms: Night sweats, fatigue, extreme itchiness, persistent cough
Treatment: AAVD chemo, clinical trial w/brentuximab (Adcetris) + nivolumab (Opdivo) immunotherapy

Mara T., Stage 2BX (Bulky)



1st Symptoms: Shortness of breath, back pains, daily migraines
Treatment: 3 rounds of ABVD, 3 rounds AVD, Radiation
Topics: Self-advocacy, mental health
Jade

Jade B., Hodgkin, Stage 2X



Cancer details: Diagnosed at 21 years old
1st Symptoms: Itchy legs and feet
Treatment: ABVD chemotherapy (4 treatments), AVD (remaining treatments)
Tylere

Tylere P., Hodgkin, Stage 3



Cancer details: Mother is a nurse practitioner; suspected cancer
1st Symptoms: Swollen lymph nodes in neck
Treatment: Clinical trial; Chemotherapy, BMT
Kayla

Kayla T., Hodgkin's, Stage 3A



Cancer details: Possibly misdiagnosed the first time; later diagnosed as grey zone lymphoma
1st Symptoms: Pulled muscle in chest
Treatment: ABVD chemo, radiation, high-dose chemo, stem cell transplant

Erica H., Hodgkin's, Stage 3B



Cancer details: Staged at 3B
1st Symptoms: Intense itchiness, fatigue, night sweats, weight loss
Treatment:ABVD chemotherapy, 6 cycles (12 infusions)

Nicole M., Hodgkin's, Stage 4



Cancer details: Staged 2 then 4 after second opinion
1st Symptoms: Extreme fatigue, persistent itching on lower half of legs
Treatment: 6 cycles (12 infusions) chemo, ABVD then AVD (dropped bleomycin)

CC W., Hodgkin's, Stage 4



Cancer details: Diagnosed at 29, misdiagnosed as mono
1st Symptoms: Achiness, extreme fatigue, reactive rash on chest and neck. Later: chills, night sweats
Treatment: ABVD chemotherapy (6 cycles)

Lia S., Nodular Sclerosis, Stage 4A



Cancer details: Most common and most treatable form of Hodgkin's lymphoma
1st Symptoms:
Extreme lower back pain
Treatment:
ABVD chemotherapy
Ava

Ava O., Stage 4B



1st Symptoms: Trouble digesting, weak immune system, raised glands, night sweats, chest pain, extreme fatigue
Treatment: 6 cycles of ABVD chemotherapy
Topics: Emotional grieving, mental health, letting go

Delishea A., Hodgkin's, Stage 4B



1st Symptoms: Extreme itchiness and dry cough
Treatment: 6 cycles of chemo, radiation, immunotherapy (Adcetris)
Topics: Finding community & support, self-advocacy
Emmanuel S. feature profile

Emmanuel S., Relapsed Hodgkin’s



Symptoms: Enlarged lymph nodes
Treatments: Chemotherapy: ABVD, ICE; autologous stem cell transplant; Targeted therapy: Brentuximab
Kelsey R. profile

Kelsey R., Hodgkin’s, Stage 2A



Symptoms: Bad leg itching with no rash, enlarged lymph nodes
Treatment: ABVD chemotherapy, radiation
Manda M. profile

Manda M., Relapsed Hodgkin’s, Stage 2B



Symptoms: Loss of menstrual cycles, iron deficiency, itching, night sweats, tiredness, night terrors, trouble breathing, difficulty concentrating, enlarged lymph nodes
Treatment: ABVD chemotherapy, radiation, ICE chemotherapy, bone marrow transplant
Samantha S. feature profile

Samantha S., Relapsed Hodgkin’s



Symptoms: Fatigue, cough, enlarged lymph node
Treatment: ABVD chemotherapy (later changed to AVD), Brentuximab, Cyclophosphamide, BEAM chemotherapy, autologous bone marrow transplant
Nicole D. feature profile

Nicole D., Hodgkin’s



Initial Symptom: Fatigue, random rash
Treatment: Chemotherapy (ABVD)
Patrick C. feature profile

Patrick C., Hodgkin’s Lymphoma, Stage 2B



Initial Symptom: Dry cough, difficulty breathing
Treatment: Chemotherapy (ABVD)
Danielle shares her stage 1 Hodgkin lymphoma story
Danielle D., Classical Hodgkin's Lymphoma, Stage 1 Diagnosis: Stage 1 Classical Hodgkin's Lymphoma Symptoms: NoneTreatment: Chemo, ABVD, Immunotherapy, Nivolumab, Brentuximab, Bone Marrow Transplant
Stepheni shares her Hodgkin lymphoma cancer story
Stephenie P., Classical Hodgkin's Lymphoma Diagnosis: Classical Hodgkin's Lymphoma Symptoms: Bumps along the neck, Night sweats, 25-pound weight lossTreatment: Chemo, ABVD, ICE, Brentuximab, Radiation, Stem Cell Transplants
Categories
Medical Experts Medical Update Article

Using AI to Detect Lung Cancer Risks With Dr. Lecia Sequist

Using AI to Detect Lung Cancer Risks With Dr. Lecia Sequist

Dr. Sequist uses AI to evaluate people's risk of developing lung cancer

Dr. Lecia Sequist is the Program Director of the Cancer Early Detection & Diagnostics Clinic at Mass General Cancer Center. For nearly 20 years, she’s specialized in lung cancer.

Observing first-hand the obstacles involved in current screenings of lung cancer, Dr. Sequist made a career switch to the research of early lung cancer detection. This led her to meet MIT professor, Regina Barzilay. Together, they created Sybil – an open-source AI tool that uses pattern recognition to predict one’s risk of lung cancer.

Dr. Sequist shares the benefits of AI in preventative medicine, how AI works to assess cancer risks, the logistics of using AI, and the importance of getting screened for lung cancer.

If we can take a step back in time and try to identify those patients who are at the highest risk before cancer is visible, and we monitor those patients closely, we have a better chance of being able to pick up the cancer when it first appears and treat it and get rid of it at its earliest stages.

Dr. Lecia Sequist

This interview has been edited for clarity. This is not medical advice. Please consult with your healthcare provider for treatment decisions.


Introduction

Tell us about yourself

My name is Lecia Sequist and I am an oncologist. My clinical area is lung cancer and I work at Massachusetts General Hospital and Harvard Medical School in Boston. 

I’ve been a lung cancer-focused oncologist for almost 20 years now. At the beginning of my career, I did a lot of drug development and clinical trials looking for better ways to treat our patients with advanced lung cancer. It’s been an exciting era in oncology when there’s been more targeted therapies and just a lot more different approaches for treating patients with cancer. 

Obstacles in early lung cancer detection 

After several years of working in that vein and especially taking care of patients, unfortunately losing a lot of patients to lung cancer, I really wanted to try and focus on early detection. Our best chance of curing lung cancer, like most cancers, is if we can find it early before it has spread and it can be surgically removed. 

We have a very hard time finding lung cancer at early stages. It usually doesn’t have symptoms or the symptoms are very mild, like a cough, which could be anything. It could be allergies, an infection, or post-nasal drip. It is really hard for both patients and physicians to detect lung cancer at the earliest stages. 

»MORE: The Doctor Fighting for Early Lung Cancer Screening

Our best chance of curing lung cancer, like most cancers, is if we can find it early before it has spread.

What work do you do now?

We need better technologies and better methods, and that’s what I started focusing my research on about 5 years ago. I have really enjoyed the ability to meet lots of new people. Early detection is a very multidisciplinary field. You have different types of medical people working in that field. You’ve got radiologists, surgeons, and pulmonologists. There are also a lot of other people outside of traditional medical fields that are interested in early detection like engineers or diagnostics companies. It’s a really exciting space. 

I’ve enjoyed that switch in my career. That switch in my focus was what got me in the same room with an engineer from MIT named Regina Barzilay. She’s a professor at MIT in computer science and electrical engineering, and really thinks about the process of cancer diagnostics in a different way than a lot of clinicians think about it. We got thinking and talking and built a collaboration and designed this model called Sybil that we’re going to talk about today.

The Benefits of AI in Medicine

Describe Sybil 

Sybil is the name of our model. It’s named after the ancient prophetesses who were Sybil, so it doesn’t stand for something. A lot of people wonder if it’s an anagram that stands for something, but it’s the name of a mythological group of women who were able to see the future. We picked that name because that’s what our algorithm is trying to do. 

It’s basically using smarter tools and computer powers to do tasks that humans can’t do or take a really long time to do.

What are the benefits of AI in medicine? 

There’s lots and lots of artificial intelligence or AI tools that are coming out, whether it’s in health care or in other aspects of our lives. I think, in a lot of people’s minds, it’s all lumped together. It’s just AI, but one thing that I’ve learned is that AI is such a general term. It could mean almost anything. It’s basically using smarter tools and computer powers to do tasks that humans can’t do or take a really long time to do. The computer can help you do it faster. 

We’ve all benefited in our daily lives from having computers help us do things, whether it’s searching for information on the Internet or navigating to figure out how to get to someone’s house. It’s that type of assistance that we’re looking for in medicine to help doctors and other healthcare providers do their jobs easier, quicker, and smarter. Not necessarily take the place of clinicians, but a tool to help us do our jobs better.

How does using AI differ from other cancer screenings? 

What Sybil and some other tools similar to it are trying to do is not necessarily use those images to tell you what’s happening today with the patient, but to look to the future and say, what is this patient at risk for?

When it comes to radiology – any kind of imaging, whether it’s an x-ray, a mammogram, or whether it’s a three-dimensional image, like a CAT scan or an MRI – in medicine, we have traditionally used radiology imaging to tell us what’s happening with a patient right now. Is there a mass? Is there a tumor? Is there a trauma? Is there a broken bone? Is there COVID right now? Is there a stroke? We always used it to tell us what was going on with the patient at that moment.

What Sybil and some other tools similar to it are trying to do is not necessarily use those images to tell you what’s happening today with the patient, but to look to the future and say, what is this patient at risk for? That’s what’s really different about the research we published is that we’re using a CAT scan that’s taken today on a patient, but we’re not necessarily looking for a cancer that’s present or visible on that scan. What we’re looking for is a background pattern of risk that is imaged with a CAT scan to tell us if this patient is in a high-risk category or a low-risk category and that’s just by pattern recognition.

Difficulties in current lung cancer screenings

It is possible that the model could also overestimate someone’s risk because of some kind of fake out. That’s why none of these things are set in stone. It’s a risk, it’s not a diagnosis.

That’s one of the main downsides with lung cancer screening right now is that our lungs are very busy places. A lot of stuff comes in and out with every breath. You get soot in your lungs, you get viruses in your lungs, you get all kinds of stuff that can cause visual abnormalities in the lungs. Either you breathe it in or your body’s reacting to what you breathe in. That’s what causes a lot of confusion for doctors today when we’re looking at CAT scans and trying to see if there is an early tumor there. We get faked out all the time by a viral infection or some other type of inflammation or a little piece of mucus that’s in our lungs. That’s why I think actually looking at future risk is helpful because it helps us cut through some of the noise that might be visible in a busy place like the lungs and really look at future risk. 

It is possible that the model could also overestimate someone’s risk because of some kind of fake out. That’s why none of these things are set in stone. It’s a risk, it’s not a diagnosis. If Person A has a 70% chance of lung cancer in the future based on Sybil and Person B has only a 1% risk, it doesn’t guarantee that Person A is going to get lung cancer or that Person B couldn’t. It just tries to risk stratify that someone’s at higher risk than someone else and you might treat them differently. If you were taking care of them, you might watch their lungs more carefully or try to modulate that risk if you could.

How AI Detects Lung Cancer Risks

Using pattern recognition to predict future outcomes

A lot of us are very familiar with AI, even if we don’t know it’s called AI. When we’re searching on the Internet, whatever search engine we use, they all have AI algorithms so that if you type in just one word out of a four-word thing, the computer seems to magically fill in the other words for you. Sometimes you wonder, how did it know that’s what I was going to type in? But it’s pattern recognition and predicting the future of what you’re going to type based on information that it knows from thousands of other people who have typed similar things, or have your demographics, or have run similar searches to what you’ve read in the past. It knows what you might search for in the future. That’s kind of what we’re doing here. 

We’ve trained Sybil with thousands and thousands of CAT scans of patients’ chests and lungs and we’ve told the model, this person ended up getting cancer, 4 years later, this person never ended up getting cancer, or this person got cancer 6 months later. The computer has learned to recognize the patterns, not in the same way that a human looks at a CAT scan. 

When a human radiologist looks at a CAT scan, they have a very systematic way of looking at it. They look at the right lung and they look at the left lung, they look at the lymph nodes, the heart, and the bones so that they don’t miss anything, but it’s all anatomy-based. Our eyes and our brains can’t necessarily see the type of underlying patterns in the data that a computer can pick out. It’s just not the way we’ve been trained or the way that we interpret visual images. 

What Sybil is doing is using all of the information contained in the digital image, and it’s looking for pattern recognition where it’s been trained to see cancer or to see the patterns that are affiliated with cancer before cancer develops. Sybil can say these scans are high-risk and these other patients are low-risk for developing lung cancer.

We’ve trained Sybil with thousands and thousands of CAT scans of patients’ chests and lungs…The computer has learned to recognize the patterns, not in the same way that a human looks at a CAT scan.

How does preventative medicine reduce one’s risk of diseases? 

It’s not giving a diagnosis but it’s risk-stratifying people. That’s what preventive medicine is all about. We know that high blood pressure is a risk factor for having heart attacks, so we screen people in their primary care doctor’s office for high blood pressure. If they have high blood pressure, we try and lower it with medicines or we recommend things like exercise or weight loss to decrease that person’s risk of a future health problem. 

A lot of preventive medicine has to do with risk reduction. How can we decrease your risk for certain diseases that may happen in the future? With a lot of diseases though, we don’t necessarily know what to screen for. The same is true with cancer. 

Cancer screening has, for the most part, been about whether we can see cancer. When you get a mammogram done on your breast, they’re looking for a cancer that’s visible. When you get a chest CT for lung cancer screening, same thing. We’re looking for a visible cancer. If we can take a step back in time and try to identify those patients who are at the highest risk before cancer is visible, and we monitor those patients closely, we have a better chance of being able to pick up the cancer when it first appears and treat it and get rid of it at its earliest stages. That’s what we’re doing clinical trials now to determine. 

The importance of getting screened for lung cancer

Lung cancer screening is available, not necessarily with the Sybil AI tool, but with standard CAT scans. It’s available today. Most people who could qualify are not taking advantage of it for a lot of complicated reasons. In order to qualify currently, you have to be at least 50 years old and you have to have smoked cigarettes in the past or a decent amount. The threshold is fairly high for tobacco history. That’s required to even get your foot in the door for screening. 

Sadly, in the US, although there are over 10 million people who are eligible for lung cancer screening, only 5 to 10% of them are actually getting it for a variety of reasons that have to do with hospitals offering it, to doctors ordering it, to patients knowing about it or wanting it. It’s a complicated issue, but we’re hardly screening anybody for lung cancer, unfortunately. 

At the same time, the disease is changing. What I see in my clinic as an oncologist, seeing people who are already diagnosed with lung cancer, we see people all the time who would not have qualified for lung cancer screening even if they wanted to get it. They’re younger than 50, they’ve smoked a lower amount than the threshold or even never-smokers are getting lung cancer now at an increasingly common rate. We think this has to do with air pollution and other types of environmental exposures, but lung cancer and people who’ve never smoked are on the rise quickly. 

In the US, although there are over 10 million people who are eligible for lung cancer screening, only 5 to 10% of them are actually getting it.

We have to change who we’re letting in the door for lung cancer screening. We have to throw those doors open wide. At the same time, it doesn’t make sense to screen every living person for lung cancer because that’s just way too many CAT scans. There are costs and risks associated with screening people who are not at high risk. We have to develop tools to figure out who is at risk and should be screened and who’s not and maybe doesn’t need screening. That’s where we hope Sybil can really fit in. We’re doing clinical trials to prove that now. We’re running a series of trials along with collaborators around the world to figure out how can Sybil help real patients.

Logistics of Using AI For Cancer Risk Detection

Is Sybil currently in use?

Sybil is run off of a CAT scan, so it’s not a separate procedure. Basically, the radiology department would take the CAT scan and Sybil is just another set of eyes to look at it. 

It’s not something that’s covered by insurance right now, but it’s not something that I would recommend for the general public right now either. We’re doing clinical trials to figure out how best to use it and what kind of information is actionable or not actionable. It’s still in the experimental phase. 

Are there costs associated with creating and running Sybil?

I think the question of cost or who’s going to pay for it very much depends on how the tool is developed. There are some computer AI tools that are being developed by companies who, just like drug companies that develop new drugs, have to recoup the cost of the development by charging for their algorithm. 

Our algorithm actually is open source. It was developed from an academic collaboration between MIT and Mass General Hospital. Anyone can use it essentially for free. There’s not a cost associated with it right now. We hope that encourages investigators from around the world to use it and study it on their own so that we can all move forward together.

Anyone can use it essentially for free…We hope that encourages investigators from around the world to use it and study it on their own so that we can all move forward together.

How far out does Sybil look to predict lung cancer risks? 

We had our research focused around up to a 6-year time horizon. That was in large part because of the big data set that we used to train the model, that was how far their follow-up went. With any kind of future predictive test, the farther out you get, you lose some accuracy. But right now, we’ve designed it to look 6 years out in the future and tell us what is this person’s risk of lung cancer.

»MORE: Lung Cancer Patient Stories

Does bias play a role in Sybil’s predictions?

With any computer algorithm, you have to be wary of bias. If you had a computer algorithm that was going to predict who could drive a car, and you only taught it how to look at 8-year-old children. Well, 8-year-old children don’t know how to drive a car yet, hopefully, or they don’t have a license at least. If you’re looking at the wrong population, you’re not going to be able to predict the outcomes. 

That’s really important to our research team as well, that we make sure that this is an algorithm that could be used globally and on people of different ages, sexes, and races. We’ve looked at it in a large group of people, but still, it’s not inclusive of all diversity worldwide. That is one of the main things we’re working on right now with our collaborators, is to try to get populations that are representative of different parts of the world and different demographics and look at, does the algorithm translate just as well or are adjustments needed to retrain it to include a certain type of person? It’s really important with any algorithm that you think about those sources of bias.

That’s really important to our research team as well, that we make sure that this is an algorithm that could be used globally and on people of different ages, sexes, and races.

The Future of AI in Cancer Risk Detection

When will Sybil be available for use?

It is available to people now, so it’s open source, but would I recommend that they use it to take care of patients yet? No, because I think we need more publications saying that this is how it was used in patient care and this is what it was good at. This is what it wasn’t able to do. With any tool that a health care provider is using, you have to know what it can do and what it can’t do so that you don’t use the tool inappropriately. 

I think within a couple of years we’ll have reports from these various clinical trials that showed what it could do, what it couldn’t do, what its strengths were, and what its weaknesses were. That’s when doctors can start to implement it as a tool that they would use to take care of a patient in front of them.

Could Sybil be used to detect the risk for other types of cancers? 

Right now, it’s only been designed to look at patterns associated with lung cancer. But that’s a really good question. Can we do similar things with other imaging or even the same imaging of a chest CT? I think that using radiology scans, which are very detailed and contain a lot of fine imagery detail about the inside of a person’s body, it’s a whole new field of how can we best use those images to improve someone’s health. There’s a big wide open universe of ideas that could go into these types of algorithms.

Do you have any advice for someone interested in lung cancer prevention?

Lung cancer screening is a very powerful tool. It’s able to save lives by finding cancer early.

Even though Sybil isn’t quite ready to be rolled out and is still being studied in the experimental phase of its development, lung cancer screening is available, and I mentioned some of the problems. It’s not being ordered on everybody or you have to be 50 and you have to have smoked the equivalent of at least one pack a day for 20 years to get lung cancer screening now. That is a lot of people who fit into those categories. So if you’re watching and you, someone you love, or a friend is a smoker or used to smoke tobacco, please tell them that lung cancer screening is out there. Tell them that they should talk to their doctor about whether they qualify for it, and if they qualify, they should definitely go. 

Lung cancer screening is a very powerful tool. It’s able to save lives by finding cancer early. Lung cancer is on the rise, so it’s really important to get screened if you’re eligible. My goal in the future is to open the doors wider so more people can be eligible.

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Categories
Breast Cancer Chemotherapy Mastectomy Patient Stories Radiation Therapy Surgery Treatments triple negative (TNBC)

Susan’s Recurrent Breast Cancer & Parkinson’s Story

Susan’s Recurrent Triple Negative Breast Cancer & Parkinson’s Story

In 2000, Susan discovered a lump in her left breast. After a fine needle aspiration, doctors told her it wasn’t cancerous. Following surgical removal, they discovered they were wrong. Susan struggled with denial but eventually came to terms with her diagnosis, and later overcame breast cancer

Nearly 20 years later, Susan was diagnosed with Parkinson’s and a few years later, breast cancer again. This led her to decide to get a double mastectomy. Rather than opting for implants, Susan chose an aesthetic flat closure which she came to struggle with after not being well-informed about the decision. 

With the support of her physician husband and family, Susan overcame Parkinson’s symptoms and 3 breast cancer diagnoses. She shares her recurrent breast cancer story with us, including what keeps her positive, how she processed having cancer, dealing with pain, her experience with hair loss, making difficult treatment decisions, and her advice for those on their own cancer journeys.

Susan shares her breast cancer symptoms and treatments
  • Name: Susan S. 
  • Diagnosis (DX):
  • Symptoms:
    • Lump
    • Twisted, caved-in nipple
  • Treatment:

Communicate whatever you’re feeling without fear of judgment from others, without concern for other people’s concern for you…Be honest with your whole truth, because some days you’re gonna feel better, and some days you’re going to feel worse.

Susan S.


This interview has been edited for clarity. This is not medical advice. Please consult with your healthcare provider for treatment decisions.


Table Of Contents
  1. Symptoms & Diagnosis
  2. Treatment Decisions
  3. Chemotherapy
  4. Remission & Relapse
  5. Quality of Life
  6. Reflections

Symptoms & Diagnosis

Tell us about yourself

I’m 72. I have a husband, 2 daughters, 2 grandchildren, and 1 golden retriever. My hobbies, up until I got to this age, my husband and I’s passion in life was scuba diving. We went all over the world. It’s the only kind of vacation we ever took. He’s an underwater photographer, so we ended up with quite a spectacular set of images that we’ve designed a house around. We built this house that we’re in 4 years ago.

When did you first discover something wasn’t right?

It was my husband loving me, and he found a lump. He’s a physician and he didn’t want to alarm me, but he also didn’t want to ignore it. So he found it without looking for it. It was a left-sided tumor. 

Getting a fine needle aspiration 

The guy had missed it 3 times when he did the fine needle aspiration. He told me I had no cancer…They sent it to pathology and they said, “Oh, that’s positive.”

We had a fine needle aspiration scheduled. The guy took 3 samples and we were supposed to go to Australia 2 or 3 days later. They got a report back and they said, “No problem, you don’t have any cancer. But we might as well take that thing out.” 

We go to Australia, we’re gone for 3 weeks, we come back. My mom is staying here with the kids and she gets this call from the hospital. They said, “We just wanted to talk to Susan about her surgery that’s scheduled in a few days.” My mother was like, what surgery? Because they told us there was nothing, it was no big deal. 

We called and the guy had missed it 3 times when he did the fine needle aspiration. He told me I had no cancer. Then we went and did the surgery and they sent it to pathology and they said, “Oh, that’s positive.”

How did you react to hearing you had cancer?

It felt like this hard little rock and it wasn’t much bigger than the size of a pea. It freaked me out so much that I never went looking for it again.

Susan discovered a lump the size of a pea which turned out to be cancerous

That was an awful day. Just like everybody else, when they first hear that news, you go numb, deaf, and blind. Fortunately, my husband being a physician, was able to ask the right questions, chase this down, and figure out what to do. 

We live in Austin, but we ended up going to MD Anderson in Houston for my care, which was tremendous. The care was great. I had a lumpectomy and they took 5 lymph nodes, all of which were negative, which was wonderful. 

»MORE: Reacting to a Cancer Diagnosis

I was in such denial. This is really pathetic, but my husband, when the lymph nodes came back negative, he knew that was really good news. I had really mixed feelings about it. Intellectually, I knew that that was really good news. But emotionally, I was still in the space I’d been a few weeks before the trip, which was, you don’t have cancer. So I was like, if the lymph nodes had been positive, it would have been proof that I had cancer. 

What did you think when you discovered the lump?

Nothing, and I felt it. He told me where to feel it. I felt it one time and I was so freaked out. It felt like this hard little rock and it wasn’t much bigger than the size of a pea. It freaked me out so much that I never went looking for it again. There’s this crazy emotional thing that doesn’t have any rationality attached to it. 

Treatment Decisions

Susan had multiple treatment options for breast cancer

Choosing the next course of treatment

The oncologist recommended chemotherapy and radiation following that, and he gave me 2 choices. I don’t know if other people you’ve talked to have had this situation, but he said, “You can either do this or you can do this. The statistics tell us that 97% of the people who do this type of chemotherapy have no return of the disease, but you do lose all your hair. This one over here, the statistics tell us that you don’t lose all your hair and is 93% [effective].” So it was a 4% difference. I really was emotional about my hair. I said I’m willing to gamble on that 4%. Let’s go with the one I’m not going to lose my hair. The doctor said, “Why don’t you guys go home and think about it? Call me if you have any questions.” We got home and we thought, We do have questions.

Getting a biopsy 

The surgeon here in Austin who did the fine needle aspiration said, “When you get back from Australia, let’s take it out.” So as far as I knew, I was taking out a benign little something and it came back positive. I never had a biopsy. Then when I went to MD Anderson, they said we needed better margins. They took another whole section in the same spot, but bigger, and the lymph nodes with the sentinel node biopsy. I had no idea how painful a biopsy was.

Susan received a fine needle aspiration

Processing a cancer diagnosis 

I learned a lot about denial. It’s a powerful human thing. I remember 2 times realizing I had been in denial. One was 9 days out. As I said, my husband’s a physician. He’s very compassionate, he loves me dearly, and he was just very present for me. 

I made plans and he figured out the MD Anderson piece. Then 9 days later, I remember driving up the driveway and he stopped the car on the hill of the driveway because I had said something that made him realize I totally was disconnected from this truth. It wasn’t internalized. We had another long conversation, and then I thought I got out of denial. 

I learned a lot about denial. It’s a powerful human thing.

There was another episode of that 4 months in. I just realized, oh my gosh, you still really haven’t grasped how serious this is.

Do you have a family history of breast cancer?

No mom, no grandmom, no aunties. I have 2 daughters and they now have a family history. That was scary. I don’t have the BRCA gene, so that’s a good thing for my kids. 

»MORE: Genetic Testing For Cancer

Chemotherapy

Wanting to quit chemo 

Susan experienced anger when she lost her hair

I was amazed at how angry I was every time my hair would fall out. It took me a few months to realize I was angry at the cancer.

We were talking to the oncologist who had a couple of choices he was happy with for me, and one would mean I would lose part of my hair and one would mean I would lose all my hair. This is the one they called the Red Devil, Adriamycin. The other one, I don’t remember what it was anymore. That little cocktail was 3 different drugs. With that one, I was going to lose maybe a third of my hair and I did. 

I was amazed at how angry I was every time my hair would fall out. It took me a few months to realize I was angry at the cancer. It was really unlike me to be semi-violent, but it was all emotion. It’s just a tough thing. 

I was scheduled for 6 treatments, 3 weeks apart, and it was IV. I Did not have a port. After the fourth one, they forgot to give me antiemetics, anti-nausea drugs. We drove back to Austin and I was sick all night. I was unprotected from the chemo and I was so miserable and so sick that the next morning I said to my husband, I’m not doing that again. I’m not getting in the car and driving over there and giving those people my arm so they can pour those poisons in me. I’m not doing that. He was so dear, so tender, and smart. He didn’t say anything. He was sitting down next to me on the bed, and he went, “No judgment.” He didn’t support what I said. He didn’t deny what I said. He just was neutral. 

»MORE: Managing Nausea and Vomiting from Chemotherapy

A call from a friend helped her push through 

I just cried for a long time, and I had an amazing thing happen. I had a friend from Denmark call me right in the middle of that refusal. As soon as I answered the phone, she could tell something was wrong. She said, “I may be able to help you.” This is a long-distance call from Denmark. She said, “It’s essentially a guided meditation and if you’d be interested, we could do this and just see what happens.” I trust her and I love her so I did. 

Susan's friend helped her through wanting to quit chemo

I was walking toward the beach in my imagination…It was the most amazing feeling. It was this sense of, there she is. There’s that healthy girl.

She had me lie down, it was sort of awkward, then take my phone. It was resting on my shoulder so I didn’t have to hold it. She said “I want you to take your right hand and point all the way out and picture you healthy. Picture a healthy Susan.” She talked in the third person and I answered in the third person and I said, “She’s on a reef. She’s swimming in this beautiful sparkling water over all this color and all this life, and all these fish. It’s just gorgeous.” She said, “Take your left hand, extend it all the way out, and tell me where you are. Tell me what you see.” I said, “I’m in this house and it’s surrounded by this huge forest and I feel like I have to go outside and I have to go in this forest and I’m really scared. I can’t see any light source. The trees are so tall and they’re blocking out the sun. But I feel like I need to go through this forest.” 

She guided me step by step and she would ask me questions like, “What are you feeling and what are you seeing?” I was walking toward the beach in my imagination. When I got to the edge of the trees and the beginning of the sand, it was the most amazing feeling. It was this sense of, there she is. There’s that healthy girl. I can see her. She’s right there, and that’s me. I kept walking and I got to be on the reef and be healthy and live. I told my husband I was willing to go back for the next treatment.

Why do you think guided meditation helped you?

Susan found guided meditation helpful in her cancer journey

Doctors failed to give Susan anti-nausea medication prior to chemo

Susan underwent three types of cancer treatments

The whole third-person part of it was so interesting. I think there’s something about the fact that it was in the third person like it keeps a safe connection. In other words, if I feel bad, I can still accept this potential as opposed to feeling bad, giving up, and having no hope. It’s not specific. It’s atmospheric.

It was really amazing. I think we were on the phone for about 2 hours. It was a crazy long phone call to Denmark.

Did you go back on anti-nausea medication with chemo?

With this type of cancer, it was not recommended that I take anything. That is my first cancer. That was a long time ago. For the more recent cancer, I didn’t do chemotherapy, but I am on a 5-year estrogen blocker and that has all the normal side effects.

What type of breast cancer and staging were you diagnosed with?  

What I remember is triple-negative. I don’t remember them ever staging it. It was invasive, so it penetrated the cell wall. That probably stages it above 1.

Susan did nearly 7 weeks of radiation

How long after surgery did you begin your next treatment?

After I did the surgery first, I did 6.5 weeks of radiation.

What was your cancer care team like?

My doctor was wonderful. The first time we talked to him, to my astonishment, he sat with us for 2 hours and 15 minutes. That’s unbelievable. My husband is a physician, so he had done a lot of research before we got there. I had such a good team that I allowed a lot of what was going to happen to be researched and recommended by others instead of having to do that myself. I would ask whatever questions I had. 

Susan remarks about the wonderful cancer care team she had

My doctor was wonderful. The first time we talked to him, to my astonishment, he sat with us for 2 hours and 15 minutes.

Adjusting plans to start chemo

After the surgery, when he was telling me about the chemotherapy and I had decided which one to go with, it was December 18th. I figured Christmas was coming and New Year’s. My birthday, my daughter’s birthday, and my granddaughter’s birthday were all the first week in January. I thought, let’s just start this after all those birthdays and all those holidays. Let’s start somewhere around January 12th. 

The doctor said, “Let’s talk about when we’re going to get started.” I didn’t even have a chance to say anything that was on my mind. He goes, “What do you think?” There was something about his body language that I thought, oh, my gosh, he’s talking about right this minute, like today. I looked at my husband. He’s sitting on his chair and he just had this completely neutral look. Not encouraging me, Not discouraging. It’s December 18th and I thought, oh my gosh, Susan, this is on you. You have to respond. You’re the only one in this room who’s going to say the next words. You got to figure out what it is and then you got to follow through with it right now. I said let’s do it. I was like, whoa. I just agreed to my first chemotherapy right now. However, I also thought, okay, that’ll be one down. One will be behind me.

He fit me on the list and my husband, poor thing. He was coming down with a virus and he had to wait till they could fit me in, which was 9:30 at night. 

I thought, oh my gosh, Susan, this is on you. You have to respond…You got to figure out what it is and then you got to follow through with it right now.

Did you have any side effects from cancer treatment?

Susan shares the side effects of her cancer treatment

Nobody knew because I had never taken any of these anti-nausea drugs before. They gave me Zofran, which was their big, super successful drug to keep people from getting sick. Well, I had an allergic reaction to it. The next day I was in a head-to-toe rash and I fainted. My mom was here. That was the fourth one. 

The first one, they gave me a great drug. I didn’t get sick. The next day, I had an allergic reaction. For the second treatment, they gave me another antiemetic, but it was a sister drug to the first one so I had another allergic reaction to the second drug. The third time around, they said, “We’re not doing that again in any form.” They gave me a third drug which worked okay, and the fourth time they just somehow forgot. The fifth and the sixth times, they got it right.

Remission & Relapse

That was awesome news, but it was a little bit stunning to discover I had a second breast cancer that was different.

Describe your surgery

Susan received a sentinel node biopsy

It was with a surgeon at a breast specialist at MD Anderson. She explained things, what she was going to do, and it was going to be a lumpectomy. She explained what a sentinel node biopsy was and how they were going to put a dye in where the tumor had been and watch what happened. I thought that was fascinating that they could see this blue dye traveling across me to the lymph system. 

I don’t remember the recovery being difficult. Not that I’d ever had surgery before, so I’m sure I had to deal with drains and stuff. I don’t remember how long I was in the hospital.

Taking preventative measures against radiation burns

There was one beautiful part of that, which is that the team at the radiation place said, “There’s this French cream and we want you to use this for 2 weeks before we even get started. Use this every day. It will protect you because eventually this radiation will be like a bad sunburn and this will really help.” 

It’s a daily treatment 5 days a week, not 7, but 5 days a week. I did what they said. I started 2 weeks with the cream. Probably 2 weeks into those 6.5 weeks, they said to me, “You’re using that cream, aren’t you?” I said yeah, I am. They said, “Most people don’t start. They don’t do what we tell them to do and they really get burned. You’re really in great shape for being a couple of weeks into this process. You’re going to be okay.” I didn’t have a sunburn feeling probably until 5, 5.5 weeks, or 6 weeks into it, which was nearly the end of it.

[The cream] is Biafine.

»MORE: Coping with Radiation Burns

Scarring post-radiation

What I did get, that I didn’t know until a couple of years ago when I had cancer, is that radiation can scar deep down. On the left side, they put the big heavy radiation blanket thing over you. All the area that was irradiated had pretty terrible scarring that I wasn’t aware of. I didn’t feel it until after they took off all my breast tissue a couple of years ago when I had a second cancer.

This image was taken at the Indians, British Virgin Islands in approximately 10 ft of water, using a Nikon D100, Nikon 10.5mm fisheye lens, a Light & Motion Titan underwater housing, and two Inon Z220-S strobes.

No warning. No awareness. No thoughts about that at all. I would associate scarring with a cut, and there were 2. One where the lump was and then one where the sentinel node was taken, but they were tiny.

Celebrating being cancer-free

I made the decision to go back to MD Anderson for the mammograms which were every 6 months for a little while and then graduated up to a year. There was just a comfort level in doing that, and that carried on and everything was negative. 

It’s 10 years later and I’m like, Whoa! Typically in 5 years, you can consider yourself in remission, if not gone. But 10 years later, I threw myself a 10-year cancer-free anniversary party and people came from all over the country. It was a lovely, lovely thing to do for myself and my friends. We all celebrated. 

»MORE: Learn More About Cancer Remission

Susan celebrated being cancer-free 10 years later

Experiencing cancer recurrence after 20 years

Another 10 years went by before I had another cancer experience. But in the interim, I got a diagnosis of Parkinson’s disease in 2015. The first cancer was in the year 2000 and the Parkinson’s was in 2015. Then in 2021, I was looking in the mirror one day and I thought, that breast doesn’t look right. That nipple looks weird. It was kind of twisted and caved-in looking. 

I went to my doctor and it was the nurse practitioner that I saw. She didn’t even have to examine me. I saw in her face real concern. Then she examined me and she said, I’d like to send you for a mammogram and a biopsy. Are you free to do that today? I said sure, I can do that. She worked the system and all that happened the same day. I had no idea what a biopsy really meant. It hurts so much. 

Susan was later diagnosed with Parkinson's

Another 10 years went by before I had another cancer experience. But in the interim, I got a diagnosis of Parkinson’s disease in 2015.

The technician needed to do 4 and she said, “So are you ready?” I thought I would do it, but I’m not ready for it. It felt like shooting with force, with velocity, with pressure. Shooting this big opening thing right into my flesh so that they could pull out a section of me. It felt like a rocket. It was so fast and so strong. It was just awful and really painful but I survived that. 

What type of cancer were you diagnosed with the second time?

I quickly found out that it was a completely different cancer than the first one I had. This one was estrogen-positive and it was progesterone-positive. One of them was ductal and the other one wasn’t. I can’t remember which was which anymore, but it was completely different. It wasn’t metastatic, lingering for 20 years. That was awesome news, but it was a little bit stunning to discover I had a second breast cancer that was different. 

Susan's second breast cancer wasn't metastatic from her first cancer

Opting for an aesthetic flat closure 

I didn’t want to have just one breast removed. I said if we’re going to do this, let’s just do this bilateral. Because the tumor was right underneath the nipple, I didn’t want to have reconstruction. I was going to end up flat. I was just working with aesthetic flat closure. That sounded great. It sounded like it would be pretty, it would be fine. Somehow I never looked at pictures. I didn’t ask and the doctor didn’t offer anything like that because I came in prepared with, I don’t want to do reconstruction. 

People could tell me all day long, that’s not who I am and that’s a social construct and that’s whatever. All those things are true, and that doesn’t touch the fact that I’m rattled here.

Not looking at pictures probably was a mistake. I didn’t not look at pictures intentionally. It just never occurred to me. As difficult as it is to look at pictures, you can learn things because I didn’t. I didn’t know until I got home and I took off all the bandages and the dressings that they took the nipples. There’s this completely flat and caved-in on the left side chest with nothing there. 

Susan opted for an aesthetic flat closure after her surgery

There are things you can do like tattoos and stuff, but they had no choice. They had to remove that because that’s where the tumor was. Intellectually, I knew better but oh, man, it was really hard. I don’t shirk away from my own image in the mirror, but I did for a long time. You just get used to it. I have so much that’s wonderful in my life and I couldn’t live in that sad place. I had to embrace it and acknowledge it, and I did. That allowed me to eventually stop being in mourning.

People could tell me all day long, that’s not who I am and that’s a social construct and that’s whatever. All those things are true, and that doesn’t touch the fact that I’m rattled here. This is hard. I just let it evolve as long as it took, but man, it was a whole lot longer than I imagined it would be. 

Quality of Life

Cancer is a bitch. It’s really hard, but it’s not the most important thing in the world.

Describe your experience with hair loss and regrowth 

At that time, I had long hair and I didn’t have chemo, but after having had Parkinson’s for 6.5 years, I decided to do the deep brain stimulation surgery. I had brain surgery and they had to shave my head for that. I didn’t lose all my hair with cancer. I lost my chest. I lost that sense of softness and femininity. Then I got robbed of my long hair which had been highlighted for years with blonde hair. 

I pictured myself for 30, 35, or 40 years as a girl with long blonde hair. Now I have no hair. When it started growing back, because of the estrogen blocker, it came back a completely different color. I knew I was dyeing it blonde and I didn’t expect it to come back blonde. I used to be a brunette, and it came back sort of black with a lot of gray. I was anticipating the gray, and that was fine. But I was like, what’s with the black hair? What’s with all this coarse, weird curly hair? Then I thought, that’s what happens to people who have chemotherapy. Their hair comes back different than they had before. I had a huge hit on my sense of self and femininity. 

Susan struggled with hair loss

I wore scarves for a while, then I wore hats, and then I wore a wig. Finally, I just said, you’re not gonna have long blonde hair anymore. You’re not gonna have long hair for years. Might as well get used to it. I put the wig aside and every day is different. It’s not the cancer but the anastrozole which is the estrogen blocker that has a thinning hair quality. It’s going to change the texture and the color, and then it’s going to make it fall out. I keep having to clean the drain in my shower and it’s a bitch. Cancer is a bitch. It’s really hard, but it’s not the most important thing in the world.

I gave myself permission to say all that. I hung on to the fact that it mattered to me, so everybody’s attempts to cheer me up were sweet, but it just didn’t touch it. 

Having a gratitude ceremony before surgery 

I’ll tell you what I did before the surgery, before I knew I wasn’t going to have any nipples, and before my hair did this. If there’s any highlight to finding out you have cancer, this is one of the best things I ever did. We built this home that I’m in just 4 years ago, and it’s just gorgeous. It’s all curvy and really cool and it’s all 1 level and the roof is flat. We overlook this beautiful scene with a river and sunsets that are just spectacular. 

Susan had a gratitude ceremony before her surgery

I went into my surgery in this great headspace.

I decided I was going to have a sunset rooftop ceremony before my surgery to thank the girls, to honor them for everything they had done for me, for feeding my kids and contributing to my sense of myself. I wrote to all my girlfriends and said I’m going to do this. I wanted to be alone. If you have any songs that you would want to send to me, my niece told me she’d make a playlist for me. Send them to her so I don’t know what they are. 

My niece and nephew were living with me when I went through the whole thing and it was beautiful to have them here for several months. Some people sent gifts which I was unaware of because they sent them to her. Before my ceremony, there was a beautiful sunset. I said we probably should go up there today and do it because we were within a day or 2 of this surgery, so we did. 

She brought all those gifts up there. My nephew, this is so sweet, he had gone up on the roof and noticed that it was kind of dusty, so he took a sponge and water and a mop and he made big hearts. He wrote “We love you,” and all these messages on my rooftop in the dust. It was so sweet. You don’t think a guy is doing stuff like that. It was really, really dear. 

Susan shares how she stays positive with recurrent breast cancer

Susan grappled with pain post surgery

I had a friend who wanted to go to Afghanistan to work with the women and children there. She was not in the military, but she had training with the military for a number of months. She went over there and was with a unit and she brought me this beautiful Afghani rug – silk, stunning, amazing rug – that was called the family tree. It had lots of animals and birds in pairs with babies and it was just so beautiful. I set that out on the roof, I put all my presents up there, and my niece took a bunch of pictures and then she went away. I was up there by myself for about an hour just soaking it all up and finding these gifts. 

That playlist is everything from I Am Woman, Hear Me Roar to The Beatles. The other thing that was so much fun, they sent tapes of themselves doing things, and one of them sent me this hilarious poem about how after you have a bilateral mastectomy, you don’t need to have them again. It was about this whole experience of joy and love. I went into my surgery in this great headspace. It was really, really cool. I put that out there for people about to have surgery.

Did you have pain post-surgery?

I don’t think it was right away. It was probably within a month. I think because you have drains, cutting, and big sutures and stuff, you expect that to hurt and it gets better every day. Apparently, there’s a phenomenon known as post-mastectomy pain syndrome. 

It hurts in many different ways, off and on throughout the day. Sometimes here [under the arm], which would make sense because they did some incision there. Sometimes it hurts here [in the center of the chest]. Sometimes it hurts here [the lower chest]. This is a little fake bra I’m wearing underneath this shirt. Sometimes it hurts here [the upper chest]. Sometimes it hurts around the back. Sometimes it’s straight across the middle [of the chest]. And when I say hurt, it feels like there’s this vacuum on the inside of me that’s just pulling, tightening, shrinking in. It takes your breath away, it comes out of nowhere, it hurts like crazy, and it doesn’t last as long as it used to. 

It’s less frequent than it used to be because of going to a physical therapist who is of the belief that it has to do with the scar tissue. Probably from the first surgery all those years ago and now more scar tissue on top of it. He’s trying to break it up and boy is that painful. He’s also doing something called dry needling, which has facilitated the process of getting healthy and having less pain. We do that every couple of weeks, and in the meantime, he wants me to push and stretch deep down in between the ribs.

It feels like there’s this vacuum on the inside of me that’s just pulling, tightening, shrinking in. It takes your breath away, it comes out of nowhere, it hurts like crazy.

Susan had to get a painful biopsy

Has physical therapy improved your pain?

Yes, it’s a little bit less intense. Definitely doesn’t last as long. I don’t have as many episodes per day as I did before. That’s all a huge relief. Yet, every night when I take off an outside layer to put on a nightshirt or jammies, just the slightest hint of cold jacks it up. Or if I’m in a room that has a ceiling fan, even with clothes on, it just hits me. I walk around a lot with my hands on my chest to keep warm. A lot of the time, here in the house, I wear a fleece bathrobe just to keep that extra layer on me of warmth.

The literature that I read about it said that it’s not that common. I read that 30 to 40% of women get it, so maybe that is a lot, but it only lasts a few months. I did join a website specifically for people who had flat closures. One woman said it’s lasted for 8 years for her now.

I could get to about here [hands raised above the head] for a week or 2. Then, once I could get to here [clasped hands raised above the head], I was really proud of myself because I had not been able to do it a couple of weeks before. And I think I made a mistake. If I had increased the stretching, moving that tissue around, it might not have gone as far downhill as it did. That’s speculation on my part, but it makes sense to me.

Physical therapy has improved Susan's pain post-cancer

What did your doctors initially do to help your pain?

I went back to MD Anderson to my surgeon, and she said, “The sutures look great.” I thought, yeah, they do, but that’s not what’s happening. She goes, “I think you need to go to the pain clinic.” I went to the pain clinic and he wanted to give me painkillers and yeah, that helps, but it doesn’t solve the problem. Then my Parkinson’s doctor didn’t want me to take the ones that he wanted me to take so I had that problem. I just went around being brave and sucking it up. And that’s not always the wisest thing to do.

How many cancer recurrences have you had?

Susan has had two cancer recurrences and Parkinson's

With the bilateral mastectomy, they sent everything to the lab. They found a completely different cancer in my right breast that the mammogram hadn’t shown. It wasn’t the same as the one in my left breast 20 years before. So I’ve had 3 different types of breast cancer in my 2 breasts. That was taken out after the surgery. It was taken out as a result of me saying, let’s do bilateral. 

Who did you receive cancer care from with your recurrence?  

In the hospital system, at least at MD Anderson, I felt like the oncologist was my doctor. But in the system, it feels like the surgeon is your doctor. I got to the surgeon through the doctor who recommended her. It turned out that 20 years later, my previous doctor was now the head of the breast surgery department. She took me on again. 

Susan stayed with her original cancer care team for her recurrences

My oncologist was still there too, which was amazing because he was an older man when I was there 20 years ago and he walked in. This was so cute. The first thing he said to me when I came back was, “Let’s figure out what’s going on with this weird-shaped nipple that we had done the biopsies on.” He walks in and doesn’t say anything about the cancer. He goes, “Mrs. Scarlett, if I’m going to have to cure you of cancer every 20 years, the next time you come in here, I’m going to be 99 years old.” A couple of times when I was getting different things done in the hospital, we all wondered how old he was.

They found a completely different cancer in my right breast that the mammogram hadn’t shown. It wasn’t the same as the one in my left breast 20 years before. So I’ve had 3 different types of breast cancer in my 2 breasts.

Reflections

Choosing to have a positive outlook

I would say a couple of things. One is having Parkinson’s disease is a game changer. When I got cancer, my husband said, “You realize in a really weird kind of way, you’re lucky here. There are more people who have breast cancer than anything else, therefore there’s been more research done for more years and we know more about it than we do probably anything else. If you have any hope of getting cured, it’s with something like what you have now.” That was 20-something years ago. 

You get Parkinson’s, it was diagnosed 200 years ago. They found a great drug that works really well. As they say, it’s the gold standard close to 60 years ago, and nothing much since then has come anywhere close to a cure. That brain surgery is phenomenal. It’s cured me of all my Parkinson’s symptoms for now, which is a real blessing.

Susan chooses to be positive

Having Michael J. Fox out there in the world, having lived with Parkinson’s for 20 years, and again, this isn’t the cancer story, but it’s part of my story. The first book he wrote after his diagnosis was called “Lucky Man.” I still get choked up when I think about that. What a title for your book. The other couple of books he’s written have similar titles about an optimist looking up. 

There was a documentary called “Still,” which is on Netflix. You may remember the scene. It’s this long shot when he’s walking and this lady walks by and she says, “Hello, Mr. Fox,” and he turns to speak to her and he just falls down and she’s startled and turns around and he says, “It was so nice to meet you, you knocked me off my feet.” Here’s the guy, he’s just fallen to the ground, and he’s still cracking jokes. It is truly inspirational to me to see and witness a story like that. 

There are more people who have breast cancer than anything else, therefore there’s been more research done for more years and we know more about it than we do probably anything else. If you have any hope of getting cured, it’s with something like what you have now.”

The other thing is, I’m reading “Man’s Search for Meaning” by Viktor Frankl. Viktor Frankl was a psychiatrist in World War II who was taken off to a concentration camp as was everyone else in his family. He was moved to a different concentration camp, and then he was moved to Auschwitz. He observed that the people who had hope and had a vision had something more than just mindless hope. They had something that they could live for. They lived and the people who were more hopeless and gave up quicker died quicker. That message has integrated itself into me and allowed me to really honor, not just my present, and not just my past, which are hugely important, but the future, too. 

To have a sense that, as they say, the sun will come up in the morning. But to care about the sun coming up in the morning, to have that as a potential is so empowering. It’s so, so important.

The importance of expressing your emotions

With my first cancer, my mom came. My younger daughter was still living at home. She was in high school. My older daughter was already on her own. Mom and I made a deal that if we had a bad moment or a bad day or we were scared, pissed off, hurting, or sick, I gave her permission to be truthful with me. If she was having a bad day, she did not try to protect me but just talked to me, and she gave me that same permission. 

My daughter was turning 16. We’re having all these kids over here for a meal, and then we were all going to go down to this comedy show. I was in the grocery store with my mom getting ready for this party, and I was overwhelmed with grief. I started to cry and I couldn’t stop. I went into the lady’s room and I cried for a long time. Mom and I had 2 carts because we were trying to be efficient, and pretty soon she realized she didn’t know where I was because I was gone, trying to keep myself together. 

Susan and her mother were both honest with each other

After I was in the bathroom for a long time, I thought I’d better go find Mom. I still couldn’t stop crying. I came out around the corner and she saw me. She was dressed all in white that day, and she saw that I was a mess. She just put her arms around me and I couldn’t even hold myself up. I just started sinking down to the floor and my mom was dressed all in white. She’s holding on to me and she goes all the way to the floor of the grocery store with her white jeans and her white shirt. She was only about loving me and being present for me at that moment. She looked up at somebody and said, “Can you get me some ice and some water?” She was just shaking and sobbing. When you are that truthful, you do yourself a service. Communicate all the time with the people who matter.

What advice do you have for someone on their own cancer journey?

Susan encourages people to communicate their feelings

Communicate whatever you’re feeling without fear of judgment from others, without concern for other people’s concern for you. Don’t keep stuff in. Believe that these people who love you are there for you and don’t try to protect them. Be honest with your whole truth, because some days you’re gonna feel better, and some days you’re going to feel worse. 

More Breast Cancer Stories

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Amelia L., IDC, Stage 1, ER/PR+, HER2-



Cancer details: IDC is most common kind of breast cancer.
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Rachel Y., IDC, Stage 1B



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Caitlin J., IDC, Stage 2B, ER/PR+



Cancer Details: ER/PR positive = estrogen and progesterone receptor positive
1st Symptoms:
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Callie M., IDC, Stage 2B, Grade 2, ER+



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Stefanie H., IDC, Stage 3, Triple Positive



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Doreen

Doreen D., IDC, Stage 2A, Triple Positive



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Melissa H., Stage 2B, Triple Negative



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Genoa

Genoa M., IDC, Stage 3, HER2+



Cancer details: HER2-positive tends to be more aggressive than HER2-negative cases
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Andrea A., IDC, Stage 2B/3, ER+



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Stephanie J., Stage 3, Triple Negative, BRCA1+



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Erin C., IDC, Stage 2B/4, Metastatic, Triple Negative



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Margaret A. feature

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Abigail J., Stage 4, Metastatic



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Bethany W., Stage 2, ER+



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Cynthia is the founder of Learn Look Locate, a breast cancer community
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Categories
Breast Cancer Chemotherapy dexamethasone Hormone Therapies Mastectomy Patient Stories Radiation Therapy Reconstruction self-advocacy Steroids Surgery tamoxifen triple negative (TNBC) Xeloda (capecitabine)

Kelly’s Stage 3C Triple-Negative Breast Cancer Story

Kelly’s Stage 3C Triple-Negative Breast Cancer Story

Interviewed by: Alexis Moberger
Edited by: Katrina Villareal

Kelly T. feature profile

Kelly was diagnosed with stage 3C triple-negative breast cancer at 33.

She regularly did breast self-exams when one day, she noticed a golf ball-sized lump on her left breast near the armpit. In that instant, she broke down and just knew that this was breast cancer.

She shares how she became a staunch advocate for herself to the point where she started treatment without an oncologist because she knew that the doctor she had then wasn’t the right one for her.

She also shares the importance of open lines of communication with your medical team, especially when she was experiencing serious mental side effects from tamoxifen.

A year after her diagnosis, she founded TNBC Thrivers on Instagram, an online community that seeks to bring together women with a similar diagnosis.

In addition to Kelly’s narrative, The Patient Story offers a diverse collection of breast cancer stories. These empowering stories provide real-life experiences, valuable insights, and perspectives on symptoms, diagnosis, and treatment options for cancer.


TW // Suicidal ideation

This interview has been edited for clarity. This is not medical advice. Please consult with your healthcare provider for treatment decisions.


  • Name: Kelly T.
  • Diagnosis:
    • Triple-negative breast cancer (TNBC)
  • Staging:
    • 3C
  • Initial Symptoms:
    • Golf ball-sized lump in the left breast
  • Treatment:
    • Chemotherapy: doxorubicin, cyclophosphamide, paclitaxel, carboplatin, capecitabine
    • Surgery: nipple-sparing, skin-sparing double mastectomy
    • Radiation
    • Hormone therapy: tamoxifen
Kelly T.


Kelly T.

Introduction

I’m a stage 3 triple-negative breast cancer survivor.

I am a content creator and founder of TNBC Thrivers on Instagram. I’m also the chat host for the Triple Negative Breast Cancer Foundation.

Besides all that, I’m a wife and a cat mama of two. I work in finance. I love travel, fashion, and makeup. That’s me in a nutshell.

Pre-diagnosis

Initial symptoms

I saw doctors regularly. I always did my breast self-exams. I checked my breasts every time I was in the shower and never felt anything.

One day, I folded my arms and noticed something that wasn’t there before. It was huge. It felt like a golf ball on my left breast. I checked the right one thinking, Do I have anything like that going over there? I immediately broke down and cried. I thought, This is breast cancer. I know this is breast cancer.

Ironically, I volunteered a lot with my local breast cancer organization in October. As soon as I felt that lump, I thought, I help women that deal with this. I think I’m about to become one of them.

No one in my family had breast cancer. They’ve had cancer but not breast. I didn’t test positive for any gene mutation. I was 33 years old. No one knows why I got this.

Getting an initial appointment

I immediately called my gynecologist. I had to wait a little bit to get in with her. She’s fantastic. She has been the backbone of finding my cancer doctors throughout my treatment.

She looked at me and said, “You’re young. You’re 33. It could be nothing, it could be something,” so she sent me for a mammogram and an ultrasound. That took another few weeks to get in.

Kelly T.
Kelly T.

When I had the mammogram, as soon as they began, they knew it wasn’t good. They said, “The doctor doesn’t like what he’s looking at. We need to do the photos again.”

I never had a mammogram before. I’m trying to keep it together so badly and trying not to cry because the first thing I want to do is cry. As soon as they said that, I just let it all out. I know this isn’t good and it’s not good.

We did the imaging again then I went across the hall for the ultrasound. They took images on the screen. I grabbed my phone, took photos, and thought, There’s something here. There’s something not good here.

The doctor came back in and said, “We want to do a biopsy immediately.” The biopsy happened in a day or two, but the biopsy results took a whole week, which is a very long time. You think, No news is good news, right? But it was the worst possible news.

Diagnosis

Getting the biopsy results

I had a kidney stone at the time and I fully believed that my body wasn’t going to get rid of that kidney stone until I found out I had breast cancer.

I was working and had to leave because I was in so much pain. I said, “I need to go to the doctor. I need to go to the hospital because I need to know where this kidney stone is.”

They took me in and scanned me. It was the day I was supposed to get my phone call. They wheeled me out of the room to get my scan and I came back to see a missed phone call from my gynecologist. She sounded happy. She said, “Hey, Kelly, it’s so-and-so. Give me a callback.” I said, “All right, awesome.”

She called and said, “You have breast cancer and you need to find a breast surgeon immediately.” It was like whoa.

The doctor came in and said, “This kidney stone is so, so close to your bladder but also, we see a mass on your left breast.” I said, “Screw the kidney stone. I got breast cancer.”

I worked with the American Cancer Society every October for the yearly walk. Being in finance, I worked in the finance tent. We organized the deposits and all the donations that they would get. I thought, People get breast cancer all the time and they’re totally fine.

Kelly T.
Kelly T.

She had to knock me down a little bit and said, “You need a breast surgeon immediately. Time is ticking. I hope you don’t mind. I already made an appointment for you with the breast surgeon at the hospital here.” I was so honored. How could I mind?

First of all, when I got the news, I was all by myself in a hospital bed. It was such a breath of fresh air. My mom didn’t know what to do. This is so foreign to us. We don’t know the first thing about breast cancer.

Learning about the triple-negative diagnosis

I met with my breast surgeon and she told me about the oncologist that I would be meeting with, who is the head oncologist at the hospital. She called him up and found out he was on vacation. She said, “We have no time to waste. You’re at least stage 3. You need to see his partner.”

I thought I caught this early. As soon as I felt it, we did something about it and it was already stage three.

I went with my husband to see his partner. We did the tumor marker test and it came back elevated. I got a 75 on that, which meant there was breast cancer present in the blood.

We sat down with this gentleman and he said I had something called triple-negative breast cancer, what my treatment plan would be, and that I would need chemotherapy, surgery, and radiation guaranteed.

He turned and looked at me and said, “Kelly, people die from what you have.” I talk about that all the time and it shakes me so much every single time. Five years later, it’s still so hard to say out loud.

I thought, No, I’m 33 years old. My life is just beginning. I just got married at 27 years old. I’m thriving in my career and doing big things. I can’t. I can’t die. I said to him, “You’re not going to let me die.” He looked at me and said, “I’ll do my best.”

I’m not angry at him. Sometimes when things don’t work out, they actually do work out. You can’t appreciate the sweet without the sour.

Kelly T.
Kelly T.
Changing oncologists at the start of treatment

The day before my first chemotherapy with this oncologist, I fired him. I was the career woman I was, very in control, even though I was so scared and so nervous and had no idea what was about to go through. This is not the doctor for me so I fired him before my first chemotherapy and got the doctor I was always supposed to have.

I feel like my current oncologist was always supposed to be a part of my story and he’s just absolutely phenomenal. I fully believe that I would not be here without him and I wouldn’t appreciate him as much if I didn’t go through what I went through. I cannot wait for the day that I get to see the first oncologist and say I’m still here.

Anytime I had an issue, I would reach out to my breast surgeon. My breast surgeon is a tiny lady, but you don’t mess with her. She will come for you, especially when it comes to her patients.

The first oncologist messed up a bunch of stuff. He wasn’t returning phone calls. I had no idea when chemotherapy was starting. The quantities of the pre-meds that I got from the pharmacy before I started chemo were all messed up. I said, “All right, enough’s enough. This is my life here.”

I reached out to my nurse navigator, who was side by side with her, and said, “Give me Cohen. Give me the doctor I was supposed to have.”

I knew this guy was something special. If you’re an elder millennial like me, back in the 2000s, there was a show called The O.C. Who was the best character on The O.C.? Seth Cohen because he was the funniest.

Kelly T.
Kelly T.

My husband and I loved The O.C. I don’t even think my oncologist knows this story. We found out I’m going to be with an oncologist by the name of Dr. Seth Cohen. We immediately looked at each other and I said, “I’m gonna be okay. We’re gonna be okay.” That was our big, funny aha moment with that.

I Googled his name and found stories of him successfully treating patients with aggressive cancers and those who didn’t think that they were going to make it and they’re still here. You say his name in the hospital and people start to shake. I thought, I don’t know who this doctor is, but I need him. He was supposed to be mine and I’m going to ensure that he is mine.

Treatment

Chemotherapy

We had two separate treatment plans. The first oncologist was only going to give me eight chemotherapy sessions considering my aggressive stage of cancer. Looking back on it now, I don’t know if I’d be sitting here if I stayed with that doctor. With his plan, I was only supposed to get four AC (doxorubicin and cyclophosphamide) and four Taxol (paclitaxel) then do surgery and radiation.

I did that first chemo without an oncologist. A lot of people don’t know that my first oncologist came to my first appointment and confronted me about firing him, which speaks to his own professional character. I’ll never forget it.

I went with my husband. The first day of chemo is such a long day. Your nurse comes in and explains everything that you need to know about chemotherapy.

As soon as she left to get the chemo, the oncologist walked in and said, “I hear that you’re going to whoever.” I said, “Are you seriously confronting a cancer patient on the day of their first chemotherapy?” He left and the nurse walked in. She looked like she saw a ghost.

She said, “I’ve been a nurse for 25 years. He was standing outside of the room listening to us the whole time. I’ve never experienced anything like that in my life.”

Kelly T.
Kelly T.

The following week, I finally met my new oncologist, Dr. Cohen. He busted through the door and said, “I heard you’re starting trouble in here.” I thought, This guy is awesome.

He said, “I reviewed your plan. It’s good, but mine’s better. With the initial plan, you may get a home run, but I’m going to knock it out of the park.”

His plan was to do four AC, eight Taxol, and four carboplatin. Back in 2018, not a lot of patients that weren’t BRCA were doing carboplatin. But considering it was already stage 3C, he said, “Carboplatin is a metallic chemotherapy and it can be very hard on the body. But you’re 33 and I think you can take it. If you’re my sister, this is exactly how I would treat you.”

Side effects of chemotherapy

We did AC first. Nowadays, they save it for the end.

My first round went very well. I didn’t have any side effects. I said, “I am superwoman, I can do this thing.”

As for the second and third, that was a totally different story. I was extremely nauseous that I didn’t want to do it anymore. I didn’t want to leave my house. My friend would pick me up and drive me around just to go driving. You have car sickness the whole time.

I tried everything. When you’re so desperate for something, you’ll try anything. Even the pre-meds that they give you to help with nausea didn’t do anything.

I said to my oncologist, “It’s bad. I don’t even know if I can continue going on.” He said, “No, you’re going to hang with me. We’re going to get through this and we’re going to figure this out together.”

I actually helped him come up with a way to help me. I was on Decadron (dexamethasone), Zofran (ondansetron), and Ativan (lorazepam). I would take them and would still be nauseous, but he would have me take them in a certain order.

I had this idea. “What if I took them all at the same time?” He said, “They won’t counteract so nothing bad will happen.” We put our heads together and that was the secret sauce.

I was on a lot of steroids. If you look at old photos of me, I do not look the way I look today. My oncologist lovingly said it would make my head the size of a football field but that was about it. I gained 13 lbs during chemotherapy because of the steroids. I also went on a health journey.

You’re fighting cancer. You get diagnosed with what they’re saying is the worst breast cancer to get. You have in the back of your mind the doctor who said, “People die from what you have,” so weight gain is the least of your worries. I just don’t want to be nauseous. Let’s get through this and, hopefully, this all works.

Kelly T.

Surgery

Preparing for surgery

I was so anxious about having surgery. It was my first surgery ever. I never had a stitch, never needed anything. Going through treatment and surgery was the part that stressed me out the most.

I literally waited two weeks before surgery to tell my breast surgeon what surgery I wanted to do, even though when we first met, it was a double mastectomy, hands down.

You are the CEO of your body so it’s still your decision on what you want to do. There might be a high recommendation for a certain type of surgery.

I was so nervous that I was starting to make a decision based on fear of what surgery was going to feel like vs. choosing a surgery that would benefit me in fighting cancer. I went back and forth between a lumpectomy, which seems less invasive, and a double mastectomy. I knew the decision I had to make. Sometimes you have to make decisions and do it scared.

Nipple-sparing, skin-sparing double mastectomy

My breast surgeon specialized in nipple-sparing mastectomy. It wasn’t that I sought after that because I’m fighting cancer, nipples or no nipples. Most breast cancer patients lose their nipples because sometimes the tumor is very close to it. Mine was in the armpit area.

If the doctors can save them, they will. I highly recommend saving yours if you can do it because it helps a lot with recognizing your body after surgery and having self-love again. They save the skin, too. I know a lot of times they cut the skin. My incisions are underneath my breast.

I was mentally prepared. I’m still going to identify with my own body. I’m just going to have more scars on my chest.

My surgery took a long time, about seven hours because I had my plastic surgeon in there as well. He put in expanders. I had under-the-muscle surgery so he helped me start the reconstruction part of the surgery.

Kelly T.
Kelly T.
Discussing with your surgeon

I would say definitely get opinions. There’s a lot about breast reconstruction and surgeries that I didn’t know.

A lot of times when you’re in that space, the information goes in one ear and out the other. With any kind of appointment that you have, I highly recommend always having somebody with you.

I had no idea there were different options: under-the-muscle surgery, over-the-muscle surgery, you keep your nipples, you lose them. There’s never a good time to have cancer, but I’m so glad I had cancer during social media because I learned so much about so many different surgery types that I didn’t even know.

I don’t know anything about breast cancer nor did anyone in my family or friends. Luckily, I had the best options laid out for me, but that’s not always the case. Everything worked out in the best possible way for me.

Some doctors are going to recommend procedures that they want to do; maybe not necessarily procedures you want to do. I scream that a million times on social media, especially when it comes to breast reconstruction. Sometimes it’s really hard to pick what breast reconstruction you want. Do you want to use your natural tissue? Do you want to use breast implants? There are complications with both.

I met with a plastic surgeon in the middle of chemo. She spent five minutes with me and said, “You need radiation. I would never give you breast implants. In fact, if it was up to me, I would talk you out of getting radiation for that reason.”

Another situation where I was so scared about having surgery, but I was very firm in having the comfort of being with a doctor that I completely trusted. You’re rebuilding my body. I knew that plastic surgeon wasn’t meant for me.

I go back to my breast surgeon and tell her. She said, “All right. I’m very close with this one plastic surgeon. Let me give him a call.” She called him and said, “I can get you in tomorrow at 8:30 in the morning.”

He is by far one of the best doctors on my team. I’m very, very blessed to have so many amazing doctors. He’s just phenomenal. Again, sometimes when things don’t work out, they actually work out. Sometimes you have to go through the bitter doctors to appreciate the sweet doctors.

Kelly T.
Kelly T.
Recovery from a double mastectomy

Recovery was the worst, but if I had to do it over again, I wouldn’t have changed a thing.

A lot of patients do over-the-muscle surgery now. I think it’s easier for both the surgeon and the patient.

When you do under-the-muscle surgery, they cut muscles and take a tissue expander, which is basically like a deflated implant, and put it underneath. You need to heal from the incisions and have them remove the tissue and if there is a tumor left. I slept in a recliner for a month and a half.

Radiation

I healed from the double mastectomy and then went on to the plastic surgeon. I met with him weekly and he would do fills where they fill saline in. I was doing I think 60 cc a week, which is actually pretty low. You can do more, but they can be uncomfortable.

Meanwhile, my oncologist asked, “Are you at radiation? What’s going on?” I said, “I’m getting my fills. We cut the cancer out, right? I’m fine now.” He said, “No, we’re not fine now.”

Ironically, my plastic surgeon and radiation oncologist fought at my first radiation appointment. My plastic surgeon said, “I get her next.” My radiation oncologist said, “No, she’s a cancer patient. I get her next.”

I had to get my medical oncologist on the phone and he said, “Kelly, you’re going to radiation.” We got all the fills in, got fully expanded, and then did radiation. I did 28 rounds, which is about a month and a half.

Kelly T.
Kelly T.
Side effects of radiation

Radiation was interesting. Some people say this is the easy part. With chemotherapy, you’re very nauseous, you have to shave your head, you don’t feel well, and all that. Surgery is physical because you’re being opened up. Radiation is like a bad sunburn, which is how they explain it to you.

I would say radiation is more mental than physical, although it is physical. As you go on and your skin gets red and you start to burn a little bit, it does feel like a sunburn.

There were times when I was lying on the table, crying, and I can’t tell you why. I was just sad. I’d be in the changing room, putting my regular clothes on, and I would just sit there for five minutes and cry. It was such an emotional part of the treatment.

I know they say that depression and anxiety is a side effect of cancer treatment. I don’t know if they know what exactly causes it, but you just feel overwhelmingly emotional and have sadness and it’s almost like you don’t know why.

It wasn’t like that all the time. You would get spurts and it would eventually subside.

Radiation is tricky. Breast implant surgery, especially having what they call delayed breast reconstruction, could change. It all depends on how well you go through radiation.

I made it my absolute mission to research what I needed to do for my skin to ensure that I could have the surgery that I wanted. I read a lot about different creams.

My radiation department highly recommended Aquaphor. Aquaphor is greasy and could stain your shirt so get a loose-fitting shirt that you don’t care about. I would put Aquaphor three times a day: after treatment, once I got home, and once before bed. I continued even when I finished treatment.

Occasionally, I would have appointments with my plastic surgeon to see how the skin is looking. I did very well. My skin got red, but it never peeled or broke open.

Kelly T.
Kelly T.

Scans post-treatment

I did six months of 16 neoadjuvant chemotherapy. My breast surgeon ordered a breast MRI once the chemo was done. They looked at the breast tissue and the lymph nodes to see if I got a complete response or not.

At my last chemo, I said to my oncologist, “I’m going to go for this scan, but I need you to give me the results.” He has a very calming aura and I said, “If it’s the worst scan ever, I know I could take that news from you so much better than her. If you give me the news, I can prepare for her.”

My breast surgeon is very serious. She will give it to you straight. Some people like that. Some people like to get told what they need to be told and it is what it is and this is what we’re dealing with.

I’m a more sugar-coated kind of person. I’ve got this aggressive, rare, high-recurrence cancer. I needed a softer approach and that’s my oncologist.

When I first met with him, I asked, “What stage am I?” He said, “You’re at least stage three, but it doesn’t matter because we’re getting rid of it.” I said, “Yes!” If you follow me on Instagram, he’ll pop up on a post every once in a while because he gave me comfort and sugar-coated the stuff that I needed to know and didn’t tell me things that I didn’t need to know.

Getting the results of the breast MRI

After the scan, I met with my oncologist. He put his arm up to give me a high five and said, “We did it. It’s a complete response.” It’s so amazing. I’m crying. I said, “Oh, I got this thing, Let’s go see my breast surgeon.”

I went to my breast surgeon. She looked at the paper and said, “Hmm, we’ll see what surgery says.” I thought, You should be happy. It’s a complete response. That’s what we wanted. That’s the overall goal here.

She was right. She’s never been wrong. I honestly wish that she would look into my eyes and tell me how the rest of my life is going to pan out because whatever this woman has said to me has been completely on the money.

breast MRI
Kelly T.

I had the surgery and there is no tumor left. However, there’s cancer in my lymph nodes. Two of eight of my lymph nodes came back positive. But here’s the kicker: it wasn’t triple-negative. It was low-grade, estrogen-positive. I said, “How does that work? Because I was zero on everything.” I had a cancer mutation.

Cancer in the lymph nodes

Cancer is really smart. When you’re getting chemotherapy, it’s dying. It doesn’t want to die. It wants to thrive. It could change its DNA so it could survive. When you’re triple-negative, you get triple-negative drugs so my body started to grow estrogen and the cancer was able to survive and it was already in my lymph nodes at that point.

This only happens to 3% of people. I always hit those low targets for some reason. I felt completely defeated.

After meeting with my breast surgeon, I met with my oncologist and the very chipper, positive-outlook oncologist sat in the office, put his head in his hands, and just sat there.

My mom was with me and I said, “This is terrifying because he’s scared. If he’s scared, then I should be scared.” He looked up at me and said, “Did they explain what this is? Do you know what this is?” I said, “Yes, it’s cancer and it’s estrogen cancer now and I can’t cry anymore. I cried already. I’m done. What are we going to do? What’s the plan?”

The good part was estrogen is very slow-growing versus triple-negative, which is very aggressive growing. By the time they found it, it was still considered low-grade estrogen cancer. Out of the whole cancer cell, only 20% of it was estrogen cancer. The rest of it wasn’t cancer at all.

Hormone therapy & chemotherapy treatment

I was put on tamoxifen and then I started Xeloda (capecitabine). Xeloda is oral chemotherapy. I did that for eight cycles, which is six months.

Kelly T.
Kelly T.
Side effects of Xeloda

He knows I read everything. He asked, “What are the side effects of Xeloda?” I said, “Hand and foot syndrome.” He said, “You may get diarrhea, too.”

I started Xeloda and within 30 minutes, my stomach hurt. For whatever reason, my body’s very quick to react.

Side effects of tamoxifen

Tamoxifen made me want to unalive myself. I was crazy depressed and emotional. I had very strange thoughts. After three days, we were on the same page and I was able to stop taking it.

When I started tamoxifen, all of a sudden, I started feeling sad and depressed.

When I started radiation, I wanted to lose weight. I was overweight at diagnosis and then gained another 13 lbs, which technically gave me an obese BMI.

I was reading so much about TNBC and came across a statistic that said overweight women have a poorer prognosis. I said, “Absolutely not.”

Being a career woman, you put your health last. This time, I’m going to put myself first and put my health first. I’m going to lose this weight. I’m in the middle of my health journey.

I’m feeling depressed from tamoxifen. I thought, Let me go exercise. Let me get some endorphins released. It was weird because it was like I was mentally me and knowledgeable enough to know what I was experiencing wasn’t normal.

I was getting bad thoughts in my head and thought, Wait a second. That doesn’t sound like me. Why would think that? Why would that pop into my head?

Kelly T.
Kelly T.

There’s a reservoir by me and I would walk around it. As I was walking around, I was hysterically crying. I called my oncologist and said, “I can’t do this. I can’t take this anymore.” He said, “Let’s give it another day. It’s still very early.” I said, “Okay.”

I got in my car and started driving home. I don’t have any hills or cliffs near me, but I had this thought of driving off a cliff. I said, “No, no, no, no, no, no, no, no, absolutely not.”

I texted him when I got home and said, “I’m getting these very weird thoughts and visions in my head.” He said, “This is not worth the quality of life. I’m not stressing over this over 1% of cancer that you may or may not have.”

It was so low-grade. My oncologist said, “What if they messed up at the lab? What if it was never estrogen? I still think you’re 100% TNBC,” so we just banked on it wasn’t worth even talking about ever again.

I took my last Xeloda in July 2019 and I’ve been cancer-free ever since.

Follow-up protocol

With surveillance, my oncologist does tumor markers, which I know is a whole can of worms in the cancer community. Most oncologists don’t do tumor markers. Mine does. Whenever I share about it, people say, “Why is your doctor doing it and not mine?” I don’t know, that’s just what mine does.

Tumor markers are one of those things that can be unreliable and I think that’s why a lot of oncologists don’t use them, but they’ve always been reliable in my case.

I get CA27-29 where anything over 38.6 is considered high and could be potential cancer. I got a 75 when I was diagnosed. When I initially finished radiation and started Xeloda, I would be in his office every three weeks and we would check the tumor markers. I had scans only if I had symptoms and if there was any kind of issue.

Kelly T.
Kelly T.
Two-year mark

The two-year mark for triple-negative is a doozy. Everyone talks about the five-year mark and the five-year mark is very important, but the two- to three-year mark is when you are most likely to recur as a triple-negative.

Two years later, I started coughing. I thought, Nope, I’m not going to go there. I’m not going to jump to any conclusions. It started getting worse. I’m in the shower and can’t breathe. I thought, It’s back. It’s in my lungs. TNBC is most likely to recur in your lungs or your brain first before it goes anywhere else.

I went to see my oncologist. The tumor markers were normal so he sent me for a chest X-ray. Having the position that he does at the hospital, he can find out scans very fast. I hadn’t even gotten to my car yet and he texted me and said, “X-ray is clear.”

I said, “You know I don’t make things up. I can’t breathe.” He ordered me a chest CT. He got the results of the scan and called me. He’s not the kind of doctor to call. He said, “I need to review this with your radiation oncologist, but I don’t think it’s cancer.”

There were spots on my left lung and there was a nodule, but we were putting all of our money on the tumor markers that everything was fine. I was prescribed steroids to help with the coughing and it did help. It forces you to stop coughing.

They described my lungs as mucky. They couldn’t really see through the left lung. They were going to wait some time and a re-scan was highly recommended. In fact, the notes from the hospital said, “We don’t think this is cancer, but we don’t think this is not not cancer.”

I re-scanned in a month or so and the lung cleared up. The spots were still there. I have my radiation oncologist on the phone and he said, “This looks like this is what radiation did. You had left-side breast cancer. A lot of times, unfortunately, with left-side breast cancer, your lungs can be affected by therapy. Not cancer and this is how it is.”

A few months later, I was out exercising and I started coughing again. I do very well with being positive and being, “I’m a survivor and cancer is in the back mirror.” I started coughing and it took me back to that place again. I texted him and said, “I’m coughing again.”

We scanned and my radiation oncologist ironically got the results on October 1st and I thought, Great. Breast Cancer Awareness Month. This is when we’re going to find out.

The scan’s totally fine and I get a diagnosis of radiation fibrosis. They saw the spots on the lung again and said, “This is as good as your lung going to look.” It’s something that comes along later on.

Kelly T.
Kelly T.

When I get these coughing episodes, I get put on steroids. Fast forward to today, I have a pulmonologist and I have to do lung exercises with her. I’m on Symbicort (budesonide/formoterol fumarate dihydrate), a prescription inhaler that has steroids in it.

It’s funny because radiation was the one that they said was so easy, but radiation is the one that gives you some of the longest side effects and hardest side effects. Radiation is the gift that keeps on giving.

Every time I cough, of course, they have to investigate. I know air quality can make me cough. Depending on where I go, my doctor told me to wear a mask. I’m more susceptible to lung illnesses. On one of my birthdays, we went to a rooftop bar, had a great time, and came home from the weekend with an upper respiratory infection.

Starting an online community

I desperately looked for survival stories and I realized that I might need to go out and find these people. Again, going back to that first oncologist when he said, “Kelly, people die from what you have.” I’m going to find the people that are thriving with what I have and living many years.

Let’s be honest. A lot of times, you see bad stories or you’ll see recurrence. A lot of people that go through cancer and get through cancer leave the community and that’s totally okay because you got to do what’s right for you. But when you are always looking at these bad stories, you’re going to think no one makes it out.

I like to say that I was the first one to coin TNBC thriver as a thing. I created it in 2019, a year after my diagnosis. I said, “I’m going to find these people.” I would search hashtags and slide into people’s DMs and say, “Hey, can I share your post? Can you write something for me?” That’s how I started it.

Kelly T.
Kelly T.

I also started sharing other breast cancers to get eyes on them and say, “Hey, I know you’re not TNBC, but you have an amazing cancer story. I would love to share it.” It became this beautiful community that I can’t even believe that it has become what it is.

People ask, “How do you find the people to share?” I don’t put a call to action. I basically go through posts on my personal Instagram and TNBC Thrivers and anytime someone says, “I’m a five-year survivor,” I reach out to them.

I have so desperately wanted to be a community leader. I sat down with many cancer organizations, young breast cancer organizations, and there wasn’t ever a spot for me. There was never a seat. I was told that I didn’t have a place there and that hurts.

Words of advice

There’s one message that I like to say and it’s something my mother told me: their story is not your story.

When I was diagnosed in 2018, there was nothing on social media where you saw uplifting stories. You had to find them. You had to aggressively search for triple-negative breast cancer and find people.

I remember going on the Internet very, very early in my diagnosis. It’s terrifying. You have TNBC and we have the highest recurrence and the lowest survival. In my heart, I thought, There’s got to be somebody thriving with this. I found stories of someone doing well. Six months later, they weren’t here. Same story over and over and over again.

I would call my mom in a panic, “Mom, I saw this person and now they’re not here. Then I found this other person and they’re not here.” She said, “A few things: you don’t know them, you don’t know their treatment, and their story is not your story.”

Kelly T.
Kelly T.

I’ve clung on to that so much. It’s so easy to be on the Internet and think, Oh, well, that person has the same type of cancer that I do and their cancer came back so that must mean my cancer is going to come back.

I remember being in year three and someone said, “Oh, my cancer came back in year three,” and I immediately thought, This could be the year for me. That is so not the case.

An oncologist that I’m very connected to said to me, “We know statistics on Google are off. They’re just off. But also what you have to remember is there are so many more medications nowadays that the statistics do not reflect those numbers.”

When I was going through chemo, they were talking about Keytruda (pembrolizumab) being in trial. Keytruda was only available for lung cancer and then for stage 4 TNBC. Now, if you have stages 2 to 3, you’re going to get Keytruda. Keytruda is helping a lot of people. Then you have a drug called Lynparza (olaparib) that wasn’t out before and that’s for people with the BRCA mutation.

There are so many ins and outs with cancer. Cancer is so complex we could not possibly be a carbon copy of each other.

Their story is not your story.


Kelly T. feature profile
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Cynthia is the founder of Learn Look Locate, a breast cancer community
Cynthia J., IDC, Stage 2B Diagnosis: Stage 2B Breast Cancer Symptoms: Architectural distortion on mammogram Treatment: Double mastectomy, radiation
Nikki M., Stage 3 HER2+ Inflammatory Diagnosis: Stage 3 Inflammatory Breast Cancer Symptoms: Centralized pain around the nipple, inverted nipple, swollen breast, differences in nipple color, warm-feeling breast Treatment: Chemotherapy, single mastectomy, radiotherapy
Margaret A. feature

Margaret A., IDC & DCIS, Stage 2B



Cancer details: IDC is most common kind of breast cancer. DCIS means cancer has not spread into surrounding breast tissue
1st Symptoms: Pain in left breast, left nipple inverting
Treatment: Double mastectomy, chemo (AC-T), Radiation

Alison R., Partially Differentiated DCIS, Stage 4 Metastatic



Cancer details: Triple positive = positive for HER2, estrogen receptor (ER), progesterone receptor (PR)
1st Symptoms: Lump in underarm/breast
Treatment: Chemotherapy, surgery, radiation, targeted therapy
Natalie
Natalie W., DCIS, Stage 0, ER+; Paget’s Disease



Cancer Details: Only 1-4% of breast cancer cases also includes Paget’s
1st Symptoms: 2cm lump found in right breast
Treatment: Lumpectomy, double subcutaneous mastectomy, hormone therapy
Margaret A. feature

Margaret A., IDC & DCIS, Stage 2B



Cancer details: IDC is most common kind of breast cancer. DCIS means cancer has not spread into surrounding breast tissue
1st Symptoms: Pain in left breast, left nipple inverting
Treatment: Double mastectomy, chemo (AC-T), Radiation
Tina C., DCIS & LCIS, Stage 3A, ER+



Cancer details: Both ductal and lobular, estrogen receptor positive. Different than breast cancer Tina’s mom was diagnosed w/ twice.
1st Symptoms: Sunken in nipple of right breast
Treatment: Double mastectomy, chemotherapy, radiation, hormone therapy

Cat L., IDC & DCIS, Stage 2B



Cancer details: IDC is most common kind of breast cancer. DCIS means cancer has not spread into surrounding breast tissue
1st Symptoms: Pain in left breast radiating from lump
Treatment: Bilateral mastectomy, chemotherapy

Categories
Chemotherapy Colon Colorectal Patient Stories Surgery Treatments

Danielle’s Stage 3 Metastatic Colon Cancer Story

Danielle’s Stage 4 Metastatic Colon Cancer Story

After overcoming stressful family matters, Danielle assumed her gastrointestinal issues were her body’s response to stress. But with ongoing constipation and abdominal pain, her husband encouraged her to go to the doctor. Her primary care physician referred her to a specialist which led her to get a colonoscopy that revealed she had a 7-centimeter tumor in her intestine. 

Many scans and tests later, Danielle was officially diagnosed with stage 3 colorectal cancer, thus beginning her cancer journey. Having received breast cancer screenings since her 20s due to a family history, Danielle later discovered that she was able to get additional cancer screenings which she now advocates for.

Danielle shares her cancer story with us, including her thoughts on working while undergoing cancer treatments, the importance of getting examined for new symptoms, how she reacted to learning she had metastasis, her ileostomy experience, and her advice for those on their own cancer journeys.

Danielle shares her stage 4 metastatic colon cancer

Danielle shares her stage 3 colorectal cancer story

If you don’t feel well, if something is wrong, you know your body better than anybody else does. Go to the doctor. If the doctor doesn’t pay attention to you or blows you off, go to somebody else. Do not wait.

Danielle A.


The interviews have been edited for clarity and length. This is not medical advice. Please consult with your healthcare provider for treatment decisions.


Table Of Contents
  1. Symptoms & Diagnosis 
  2. Treatment
  3. Living With Cancer
  4. Ileostomy 
  5. Quality of Life
  6. Reflections

Symptoms & Diagnosis 

Tell us about yourself

My name is Danielle Archer. I am a wife, a mom, and a mental health therapist. I live in central Florida by way of New York. I’ve been in central Florida since January of 2004. In my spare time, when it’s not blazing hot outside, we like to go to the amusement parks. My husband and I like to go to concerts, hanging out at home. We’ve got really great neighbors and we like to do stuff with our neighbors. Watch movies, listen to music, things like that.

What were your first symptoms?

I was having pain in my abdominal area. I would have to go to the bathroom and I would go, but nothing really would happen. It felt like I was hitting a wall and it was painful.

I want to say it was around September of 2018, I started having some, of what I thought were, gastrointestinal issues. Years back, I lived in California for a couple of years and when I lived in California, I was diagnosed with IBS. 

There was a lot of stress in my family. My daughter, who’s now 21, was diagnosed with gastrointestinal stuff. We had just gotten through all of that. I had thought at the time that because everything had calmed down in the family, my body was responding and I was just feeling really off. 

It was September or October and I was having pain in my abdominal area. I would have to go to the bathroom and I would go, but nothing really would happen. It felt like I was hitting a wall and it was painful. I would get up and I’m like, No, I still have to go, and nothing would happen. This was repeated. 

»MORE: What Does Cancer Feel Like?

Did you tell your doctor about your symptoms?

I called my primary care physician. They said to try this and that. Finally, my husband was like, “Just go to the doctor. Go get checked out, and see what she says.” 

I’m not really a doctor person because I don’t like doctors. Thankfully, up until now, I’ve never really been sick so I haven’t had to go other than my physical exam. 

I went to see my primary care physician and she’s like, “All right, what’s up? You never come here other than for your annual exams. I know something is wrong.” I’d made a list of all the symptoms that I was experiencing. She was like, “All right, it’s probably nothing, but some of these symptoms I’m not comfortable with. Let me send you to a specialist.” 

I went a couple of weeks later to a specialist in November of 2018. He listened to my symptoms, He’s like, “You’re a little bit older.” I was in my early 40s at the time. “You’ve had a couple of kids. It sounds like you may have pelvic floor disorder.” I looked it up because I didn’t know what that was, and I looked at the symptoms. I’m like, that kind of tracks, cool. He’s like, “But just to be on the safe side, just to rule everything out, I’m going to do a colonoscopy and endoscopy for you. I want to make sure we’re not missing anything.” 

Getting colonoscopy prep

I scheduled the colonoscopy and endoscopy for December 31st of 2018. My husband’s an attorney. I knew it was a day that he wasn’t going to have to be in court. I was like, let’s just do it and we went at 6:00 in the morning. 

I did the prep before. If you haven’t had a colonoscopy, if you do a prep, you don’t go anywhere that day, ever. But nothing happened when I did the colonoscopy prep. I did [go to the restroom] a little bit, but not very much. Not like what’s supposed to happen when you do a colonoscopy prep.

Family history of cancer and getting preventative screenings 

It was just painful and excruciating. I couldn’t figure out what it was. It was really hard to describe what the feeling was to anybody, even to my doctor. Because of my age, I was 42 at the time, so they didn’t really look at it. I know now that I was eligible for screening for other types of cancer. 

If you have a family history of cancer, it’s not just this type of cancer you can be tested for. You can be tested for everything. I found that out the hard way.

My mom passed away from breast cancer when I was 16, so I had been getting MRIs, CTs, and mammograms since I was 29 years old. I wasn’t aware that because of my mom’s family history of breast cancer, I was actually eligible to be tested for other types of cancer early. If you have a family history of cancer, it’s not just this type of cancer you can be tested for. You can be tested for everything. I found that out the hard way. 

Danielle had a family history of breast cancer, but her cancer was unrelated to genetics

»MORE: Genetic Testing For Cancer

Receiving a diagnosis post-colonoscopy

When I did the colonoscopy, I woke up and I was throwing up, which I never do under anesthesia. The doctor came in. He was a very wonderful doctor. I’m still kind of out of it, and he’s like, “You have this bleeding, festering 7-centimeter mass in your rectosigmoid junction.” Without telling me I had cancer, he’s like, it looks like it’s cancer. 

I’m waking up thinking he’s going to be like, you’re a hypochondriac. Get out. Go home. It wasn’t a Hallmark movie where there was a big dramatic reveal. I wasn’t crying. It was like, okay, then I was just checking out. They gave me a We were driving home, I looked at my husband and I was like, “Did he tell me that I have cancer?” He’s like, “Yeah.”

“You have this bleeding, festering 7-centimeter mass in your rectosigmoid junction.” Without telling me I had cancer, he’s like, it looks like it’s cancer.

Treatment

Getting tests and deciding on a treatment plan

It wasn’t until later in my journey that I thought about getting a second opinion. It was just like, you have cancer, here’s a doctor’s number, and start making appointments. Just start doing the things, and that’s what I did. I met with a colorectal surgeon. I scheduled all my appointments with the colorectal surgeon. I had a CT scan done and a rectal MRI done, which is amazing. That is an experience for the books. They need to come up with a better way to do those. 

In between meeting with the surgeon and the oncologist before getting my official diagnosis, I had all these tests done, and then I met with the oncologist. They decided the best course of action. There’s something called a tumor board where the doctors get together and they decide this is what we’re going to do. They decided that surgery was going to be my best route first. 

If you’re looking at a picture of your body, right before everything passes out of your body, there’s this final curve in your intestines right before the end. This is where my tumor was, which is why I wasn’t going to the bathroom. It was completely blocked. 

Having surgery to remove the tumor

They said that it had spread to 9 of 26 lymph nodes, so I would have to start chemotherapy.

Danielle' cancer spread to her lymph nodes so she had to begin chemo

The surgeon was like, “We have all these different options, but because of where your tumor is, there’s a possibility that you will have an ileostomy, but probably not.” In February 2019, I went in for surgery. When I woke up from surgery, my husband was like, “They bagged you.” Because of the size of the tumor and where it wound up sitting, the height of it, they had to go in and they had to give me an ileostomy. I was supposed to have that for 6 weeks for my stitches to heal. 

They sent me home with a PICC line in my arm, and then I had to sit on hydration every day for 8 hours. They gave me this fantastic plastic pole to hold this big bag of saline. It was like this plastic pole that didn’t hold the saline. It kept falling over and there were no wheels. I’m carrying this thing. It was a mess. I had a home health nurse come and they taught me how to change my saline and to keep myself hydrated. 

One of our daughters was getting married in the middle of all this, so I had to try to hide my huge PICC line in my arm, when we were doing pictures. It was a lot going on, but during that process, we had gotten a call back from the doctor. They did the surgery, they did the tumor removal, and then they tested my lymph nodes. They said that it had spread to 9 of 26 lymph nodes, so I would have to start chemotherapy. I said, “Well, what about my ileostomy?” And he goes, “You have to keep it in until after chemotherapy is over because we can’t risk doing surgery on a lowered immune system.” 

What was your staging and official diagnosis? 

I put in all my symptoms and the first thing that popped up was colon cancer. I was like, I don’t have colon cancer…Even though that’s what it said it was, I didn’t put any stock in it. Who self-diagnoses themselves with cancer? You just don’t.

Stage 3 colon cancer. Some of my records said colorectal cancer, some said rectal cancer, but it’s essentially colon cancer. I was stage 3 at the time I was diagnosed. 

The symptoms that I was having were really explainable. You don’t think that you have cancer. I don’t recommend anybody go on WebMD to diagnose yourself, but I was like, I need to figure out what this could be to try to give myself some relief until I go to the doctor and find out what it is. I put in all my symptoms and the first thing that popped up was colon cancer. I was like, I don’t have colon cancer. That’s stupid, I don’t have that. I was always like, I’m going to get breast cancer. I’m not getting anything else. Even though that’s what it said it was, I didn’t put any stock in it. Who self-diagnoses themselves with cancer? You just don’t. If I had waited any longer, who knows at that point?

Was your cancer diagnosis related to a genetic predisposition? 

After they did all the testing, my oncologist basically said you got cancer because of bad luck. It’s not hereditary. There were no genetic markers. There was nothing. I downplay it, but I have a fantastic oncologist. 

Starting chemotherapy 

They started me on chemotherapy. I went in March 2019. They put a port in my chest because they do the chemotherapy intravenously. I would go to the cancer center and sit for 4 hours. They pump me full of chemo and then they would give me chemo to go. At the end, they would give me 1 to take home for 48 hours, and then I would go back and they’d flush it. 

»MORE: Chemotherapy FAQs & Patient Stories

I tolerated chemotherapy really well. I would leave chemotherapy, go back to work, pick my kids up from school, and take my kids to school…Our lives weren’t really stunted by it.

I started chemotherapy on April 1st of 2019, about 3 days after my husband went in for emergency open heart surgery. There was a lot happening. I did 12 rounds of chemotherapy. In September of 2019, I had my ileostomy reversal. In November 2019, I was declared no evidence of disease. 

What did your follow-up scans show?

My first follow-up scans were 3 months later in February of 2020 and they showed metastasis to my liver. I went in for a biopsy in March 2020 and got diagnosed with metastatic colon cancer in my liver. It meant it was the same kind of tumor, not a new one, it just traveled. 

They put me back on chemotherapy, which was a higher intensity for 8 weeks, then I had a tumor removal surgery in June of 2020. They put me on oral chemotherapy for maintenance purposes. I had my first follow-up scan in August of 2020, and it showed lesions in my liver and my lungs. They pulled me off the oral chemotherapy and put me back on IV chemotherapy. But at that time, we were just monitoring it. They weren’t saying it was cancer. My doctor was like, “People have lesions in their chest. It could be from anything, but we’re putting you back on chemotherapy just to be on the safe side.”

I went in for a biopsy in March 2020 and got diagnosed with metastatic colon cancer in my liver.

Did you have side effects from chemotherapy? 

I was very lucky. I tolerated chemotherapy really well. I would leave chemotherapy, go back to work, pick my kids up from school, and take my kids to school. We were going out, we were doing stuff. Our lives weren’t really stunted by it. I was very lucky in that regard because not everybody reacts that way.

Are you on any clinical trials?

I don’t qualify for any right now based on the type of tumor that I have and what the genetic makeup of it is. I went to the colorectal cancer conference in September as a volunteer for the Colorectal Cancer Alliance. I met some great people there and they were able to help me out and give me some different ideas. I’ve been genetically tested. I’ve been blood tested. I’ve gone through all of the testing and all of the things, so right now I don’t qualify for anything else.

Living With Cancer

Getting caught up in making the “right” choices for your health

It’s been recommended to go plant-based. On the flip side, a lot of oncologists are like, “We just want you to eat. We want you to keep your nutrition up.” That becomes a difficult task as a cancer patient because once you start learning about all these different things you could be doing for yourself and doing for your body, it becomes, what if I don’t do this? I should do this. Well if I do this, is this going to help, or is this going to hurt me? Even 4 or 5 years later, I’m still in that position of, I’ve got Dunkin Donuts coffee. Should I not be having my iced coffee? Should I? It becomes a very difficult situation because you don’t know what the right thing is, but everybody’s body is so different.

Remembering that everyone is affected by cancer differently 

When I see somebody pass away from the same kind of cancer and the same kind of diagnosis that I have, it’s like, why them and not me?…It’s a really weird space to be in.

I’m on a treatment right now that most people are on for 5 or 6 months before it stops working. I’ve been on it for almost a year and it’s still working for me. For the oncologists, it’s a really hard thing to predict because you’re dealing with individual body chemistries and so many other factors. Which is why, when I see somebody pass away from the same kind of cancer and the same kind of diagnosis that I have, it’s like, why them and not me? But it’s like, that’s them. It’s a really weird space to be in.

How much time passed between being NED and having metastasis? 

There were 3 months in between when I received my scans. In this day and age, you’ve got access to everything. I pulled up my medical records and went to Dr. Google. I showed it to a friend who’s a nurse and she’s [shaking her head]. Then my follow-up with my doctor was in March. He’s like, “This is what it looks like, but we’re going to go do a biopsy just to make sure.” When the biopsy came back, he’s like, “Yeah, this is what it is.”

How did you process having metastasis? 

Again, it wasn’t like a Lifetime movie. It was just like, all right, now what do we do? I live my life in 3-month increments because I get scans every 3 months without fail. What do my scans say? What does the doctor say? Okay, now I can plan the next 3 months. That’s just how I’ve learned to operate.

»MORE: Reacting to a Cancer Diagnosis

I live my life in 3-month increments because I get scans every 3 months without fail. What do my scans say? What does the doctor say? Okay, now I can plan the next 3 months.

What have the results of your most recent scans shown?

I had my most recent scan in July. Everything seems stable, so I’m very lucky. Everything right now is staying in my lungs and my liver. I did a month of radiation in December of 2021 to my lungs and my liver and then resumed oral chemotherapy. I’ve done everything, so I feel lucky in that regard because it’s just in these 2 places and I’m not getting new tumors. They’re not spreading and they’re not necessarily getting bigger to where there’s a major concern. It’s so weird when you have cancer, the things that you take as a win.

Ileostomy 

Do you still have an ileostomy bag? 

No, I got that reversed in November 2019. I’ve got a decent quarter-sized scar on my abdomen, on my right side from that.

Describe what an ileostomy is

The ileostomy is, they basically reroute your intestines to the outside of your body. It’s this very small piece that is probably a half inch that sticks outside of your body. It’s covered by a special bag, and that’s where you go to the bathroom. It doesn’t make it down your intestines. That reroute was done to bypass my stitches so my stitches wouldn’t get infected. 

There are people that have a permanent ileostomy depending on their individual situation. It’s also different from an ostomy. It’s nicknamed Barbie butt because they sew your butt shut and then you never go to the bathroom again. That’s, I believe, lower in your intestines that they do that one.

»MORE: Navigating Life with an Ostomy

Do you have recommendations for anyone new to having an ileostomy?

Ask a lot of questions. They taught me and my husband how to change it when I was in the hospital. I didn’t grasp a lot of it and I didn’t ask. My husband was like, “It’s cool. I got it,” so he was doing it for me. But then he went in for open heart surgery. Luckily his office was next to a home health office and we had a very good relationship with them. I went over to them when he was in the hospital, like, “Can somebody help me here?” One of the nurses would help me change it until I figured out how to do it myself. 

There are times that I miss it because there was a level of convenience. Everybody’s experience, of course, is different. But for me, it really wasn’t that bad once you learn to live with it.

I always had extra stuff with me, just in case. Making sure you’re staying hydrated, and keeping up the nutrition. Eating corn is a whole new experience when you have an ileostomy. It’s like popping popcorn. It’s the weirdest thing.

There are times that I miss it because there was a level of convenience. Everybody’s experience, of course, is different. But for me, it really wasn’t that bad once you learn to live with it. I mean, it still sucks, but I also think that things could have gone a lot worse for me.

Quality of Life

Were you working throughout your cancer treatments? 

Fortunately for me, my husband and I are both self-employed. It was very helpful because when I got diagnosed and you’re doing 8000 tests and 8000 doctor’s appointments and you’re going in and out, I was able to work around that and take time off whenever I needed to. I don’t have to work. I love what I do for a living. That piece of it was really convenient for me. 

About 3 years ago, I took a virtual position working for an online mental health company. It’s a weird thing because you don’t know if you should tell people that you have cancer or not. You never know how anybody’s going to react. Technically, nobody’s supposed to discriminate against you because you have a disability, which cancer for some reason is listed as a disability. But I took this job and we had requirements, just like any other company that you work for, especially mental health. You’re supposed to meet with so many clients a month. 

I told her I had to do radiation for an entire month. I messaged my supervisor, who was really responsive. She’s like, “Well, I’ve got to run it up the chain.” I said, “Just for this month, I need to see 5 less clients a week.” I made every meeting, every training, and all my other appointments. I barely missed anything. She hadn’t gotten a response from anybody and it was a couple of months before somebody messaged me. Finally I messaged her and said, “Listen, if I’m going to get in trouble, I’m gonna get in trouble. I’ve got to do this. If the higher-ups want to come at me with it, that’s fine. I have no problem getting in trouble for this.” 

»MORE: Working During Cancer Treatment

A couple of months after my radiation ended, I finally got a response, “Okay. If it goes any longer, we may have to talk about you going from W2 to 1099 as a contract employee because that may be better for you.” I found out after I separated from the company that they had a supervisor’s meeting. In the meeting, one of the higher-level people said, “She’s made this request to see 5 less people a week. We’re just going to tell her she’s got to be at 1099 instead.” The corporate attorney was like, “You can’t do that.” Just for 5 hours a week, like really? I’ve got cancer. I get great reviews from my clients. I got great reviews from my supervisors I’ve met. I’ve taught workshops. I’ve done all of the things. That was a really difficult thing for me. 

Working through insurance and the cost of cancer treatments 

I’m paying almost $1,000 a month on payment plans and that’s with insurance, so the cause of cancer is very expensive.

On the flip side of that, because I’ve been self-employed, I don’t qualify for disability. I don’t qualify for Medicaid because I haven’t paid enough into Social Security to get any disability, so that becomes part of it too. Now we have health insurance, which is great but even with that, there are co-payments. We have a very high deductible that we have to meet. I’m still paying for my surgery from 2019. Since I spoke to you last, I got 3 new medical bills that I’ve got co-payments for. I’m paying almost $1,000 a month on payment plans and that’s with insurance, so the cause of cancer is very expensive. 

Then you fall into the category of working versus not working. I can’t work a regular job because I have to take time off. I go to treatment twice a month on Mondays. And what if I have a couple of unexpected hospitalizations? You’ve got that. It’s really hard for cancer patients, especially those who are still able to work. Disability doesn’t pay a lot of money, not enough for somebody to live on. That becomes really difficult as well. It makes me think of the people who are not in my position who are struggling. We’re able to make this work but there are so many people who can’t.

»MORE: Financial Toxicity of Cancer Treatment

Do you have advice for those on cancer treatments who want to work?

I guess, being in a place where it’s more accepted by people. People are more flexible for people that have not just cancer, but other chronic diseases that are still able to work and that want to work. 

One of my best friends, she’s young, she’s 34, and she’s got all these post-cancer medical issues, but she wants to work. She’s in a position where it’s either she’s on disability or she works. She can’t do both. She’s got to be on state health insurance because she can’t work. It really makes it difficult for people to still be functional.

Do you still get scans?

I would go for MRIs on occasion. The MRIs were the worst for me. At first, they weren’t bad, but I call it being strapped to the table Silence of the Lambs style because they don’t want you to move. You’re strapped to this board and your head first in a closed MRI, and you’re in there for 45 minutes. The last time I did one, an Ativan was fantastic. It was fantastic for it. Fortunately, I haven’t had to do an MRI in a little bit. 

I’m fortunate because my scans are like 5, 10 minutes. I go in feet first. They do my chest to my abdomen. They hook me up to an IV. They pump the contrast through my arm so that they can get a different visual. I think it takes me longer to drive there and get the contrast hooked up than it does for them to do my actual scans. 

Coping with scanxiety 

Again, I’m very fortunate because I don’t have all of the things, but I have anxiety because it’s like, okay, I got to do this again, what are my scans going to say? And then I check my electronic chart every 5 minutes, I get my results, and I don’t see my doctor after 2 weeks. I sit with these results for 2 weeks and what do they mean? There are those pieces of it that are difficult as well. 

You do become sort of a pseudo-medical expert. We learn way more about blood tests and blood types and what blood levels mean. Me and my friend in California compare our blood panels with each other all the time. There are things that you learn about yourself and your body and medicine in general, because all of a sudden you have to be cognizant of these things and you have to become an expert of these things. 

What’s happened is we have symptoms that we blow off. Our body betrays us because you think it’s one thing and it’s like, nope, it’s this. At least for me, I became hyper-vigilant. With a headache, I’m like, okay, do I have a brain tumor? My chest hurts. Have the tumors grown in my chest? It’s that constant background noise. I have a white noise machine that I use when I’m working with clients. It’s like a white noise machine. It’s always there in the background.

The difficulty of having age requirements to get cancer screenings

That’s the hard part about it. They just changed the age for colonoscopies from 50 to 45. I think you’re able to get it at like 43 or 42 if you’ve got a family history of cancer, but a lot of the people that I know that have colon cancer are in their 20s and 30s. If it were me, I would say stop with these age requirements because the age requirements are BS. 

We’re living in a society where our environment sucks. The amount of wildfires happening in Canada that have polluted the air down in New York and beyond, and now the stuff in Hawaii. You’ve got 911 from 911. 

I’m from New York. I’ve got friends that were first responders. One of my friends just finished breast cancer and had a double mastectomy. You have all these different factors. Our foods are genetically modified. Girls who are 12 and 13 do not look how I looked at 12 and 13 at all. There are all of these other factors that are involved. To have a minimum or an acceptable age where insurance starts covering these tasks I think is a bunch of crap. My friend is 34 years old. She cannot have children. I’m having colon cancer and cannot have children because of all the treatments.

If it were me, I would say stop with these age requirements because the age requirements are BS.

Missing cancer diagnoses in young people

That’s the thing too, is a lot of times if you’re younger or if something doesn’t fit into a medical model or a symptom checklist they say, oh, this isn’t this. You have that with WebMD. You put in the symptoms and this is what they tell you that you may have. If it doesn’t fit those categories, then you get dismissed. You’re too young for this or, oh, you just have this or that, or you get blown off completely. A year or 2 later, something happens. There are stories you hear all the time about 18, 19, and 20 years old. 

The cost of food, the cost of living and eating healthy is way more expensive. Fresh fruits and vegetables don’t last as long so you have to go to the store more often. People can’t afford that.

Reflections

Getting checked when new symptoms arise

I tell people this all the time. If you don’t feel well, if something is wrong, you know your body better than anybody else does. Go to the doctor. If the doctor doesn’t pay attention to you or blows you off, go to somebody else. Do not wait. It may be nothing, but if it’s something, maybe you can catch it early enough to get it taken care of. 

There are so many treatments out there. There are so many options out there. Not every diagnosis is a death sentence. Not everything is going to be tragic. But putting it off because you’re afraid of what may happen can be more detrimental to you than addressing it now. Make sure you’re taking care of yourself and identifying the best way for you to achieve that. 

How to be supportive and unsupportive towards cancer patients

Dealing with cancer is hard enough without being browbeaten or judged about how we choose to handle it.

When you get diagnosed with cancer, you get all sorts of advice, all sorts of unsolicited advice. I’ve gotten copper water, essential oils, you name it, I’ve gotten it. People mean well, they really do. I remember when I first got diagnosed, I was working with a client and she’s like, “Oh if I got diagnosed with cancer, I wouldn’t do chemotherapy. That stuff’s just poison.” Cool. Not the thing that I wanted to hear, but I get what she was saying. Or, my sister’s cousin’s uncle got that kind of cancer and he died. Not helpful, not helping me. 

The best way to support someone is to say, I’m here if you need anything, just let me know what it is that you need. Period. We shouldn’t be judging each other’s journey or the choices that we make. There are people who don’t get chemotherapy and try to go a natural route, and that works for them. There are people who do both and there are people who just go traditional. That’s fine. Again, everybody’s different. Dealing with cancer is hard enough without being browbeaten or judged about how we choose to handle it.

Do you have any advice for those on their cancer journeys?

Take advantage of the times that you feel good and honor your body when you don’t.

Joining a cancer community is great. If you’re on Twitter, cancer people are the funniest people on the planet. We’ve got the best sense of humor because we’re very twisted. We use a lot of dark humor to cope. If you ever need to be amused, go follow cancer patients on social media. There has to be some levity with the seriousness of it. 

Having a cancer community is important because there is a level of understanding that you’re not going to get anywhere else. Not that your friends and family are not supportive, I’m not saying that at all. But people who go through it are in the trenches with you and go through the treatments and the surgeries and all the side effects. They can identify and assist you in a way that other people can’t. I think that’s really important.

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Barbara M., Colon Cancer, Stage 3



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1st Symptoms: Stomach discomfort, difficult to process food
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Lindsay D., Colon Cancer, Stage 4



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Lee J., Colon Cancer, Stage 4, Recurrence



Cancer Details: Recurrence then remission
1st Symptoms: Discovered stage 4 cancer from unrelated CT scan
Treatment: Neoadjuvant chemo (FOLFOX), hemicolectomy (partial colon surgery), adjuvant chemo (FOLFOX), chemo post-recurrence (FOLFIRI), liver surgery

JJ S., Colorectal Cancer, Stage 4



Age at Diagnosis: 27l



1st Symptoms: Abdominal pain, blood in stool



Treatment: Surgery to remove tumor, chemotherapy, clinical trial of Keytruda (pembrolizumab)
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Symptoms: Constipation, fatigue, shortness of breath
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Angelica A., Bowel Cancer, Stage 3

Symptoms: Fatigue, anemia, irregular bowel movements, loss of appetite, heavy periods Treatment: Laparoscopy, chemotherapy, partial hysterectomy
Danielle shares her stage 4 metastatic colon cancer
Danielle A., Colorectal Cancer, Metastatic Stage 3 Diagnosis: Stage 3 Colorectal Cancer Symptoms: Abdominal pain, constipationTreatment: Surgery, Chemo
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Keith H., Colorectal Cancer, Stage 4 Diagnosis: Stage 4 Colorectal Cancer Symptoms: Abdominal painTreatment: Surgery, Chemo
Sherrie shares her stage 4 metastatic breast cancer story
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Categories
Chemotherapy Immunotherapy Melanoma nivolumab (Opdivo) Patient Stories Radiation Therapy Rare Skin Cancer Surgery Treatments

Chris’s Stage 4 Mucosal Melanoma Story

Chris’s Stage 4 Mucosal Melanoma Story

With no pain or abnormal symptoms other than a small zit-sized lump, Chris did not think much of his condition. After a new lump appeared, he decided to get checked. Doctors were also unassuming but recommended he remove the lumps through surgery. Shortly after, Chris was diagnosed with stage 4 mucosal melanoma.

With a low survival rate, Chris found hope in a clinical trial for tumor-infiltrating lymphocytes (TILs) but was removed from the trial due to brain metastasis. With the trial window closing, Chris raced to get radiation treatments done in order to rejoin the trial and was successful, as was the clinical trial.

Chris shares his mucosal melanoma story with us, including why he chose to maintain a positive outlook, the side effects he experienced from cancer treatments, his aspirations of sharing cancer advocacy, and his advice for those on their own cancer journeys.

Chris shares his mucosal melanoma symptoms, staging and treatment

  • Name: Chris W. 
  • Diagnosis (DX):

  • Age at Diagnosis: 41
  • Staging: 

    • Stage 3C
    • Advanced to stage 4

  • Symptoms:

    • Sweaty rectum
    • Zit-sized lump in rectum that grew
    • Lump that developed in right-groin

  • Treatment:

Chris shares his mucosal melanoma timeline

I feel like I’ve learned to live a more meaningful life because of the experience. I don’t have the physical or mental energy to want to go do what I used to do. The energy I do have, I want to put towards more positive good and being able to help.

Chris W.


The interviews have been edited for clarity and length. This is not medical advice. Please consult with your healthcare provider for treatment decisions.


Symptoms & Diagnosis

Tell us about yourself

Chris lives in Dallas and loves outdoor sports and activities

My name is Christopher. I’m 41 years old. I live in Dallas, Texas. I’m originally from Colorado Springs and moved to Southern California when I was younger. I grew up there until right before high school and have lived out in Dallas ever since. 

I’m into any action sports like snowboarding and anything with an adrenaline rush. I played baseball growing up as a kid and am a very proud uncle of 8 nieces and nephews. 

I’m very excited to be here and share my experience.

What were your first mucosal melanoma symptoms? 

At the beginning of 2018, I had a sweaty rectum and I didn’t know what was causing it. There was a very small lump on my rectum. I thought it was a zit or something like that. Over time, it ended up growing to maybe the size of a dime. There was no pain, there was no bleeding. I had heard what hemorrhoids are and I assumed that’s what it was so I didn’t do anything about it. 

Lumps from Chris's Mucosal Melanoma
Lumps from Chris’s Mucosal Melanoma

A few months after that, in May of 2018, I started noticing a lump that grew in my right groin and it grew rather quickly. I went to the doctor to have him look at that. I didn’t associate anything between the 2 lumps, but I had the doctor look at it and he said, “Here’s some antibiotics. Take them for 10 days and come back.” 

I came back after nothing happened. He gave me a different antibiotic and it was the same thing. He referred me to a general surgeon to get it looked at and he said he thought the lump in my groin was most likely a femoral hernia but he wasn’t sure. The only way to find out is to get in there and cut it out. He said if it was a hernia, he would fix it and we would go from there. 

»MORE: What Does Cancer Feel Like?

Receiving a cancer diagnosis

When I woke up, he said it was not a hernia, it was a lymph node. He was able to get it out with clear margins and send it off to pathology. Since I had that week off, I went to the proctologist and he said [the results] didn’t come in yet, but they should be there by that afternoon or the next day. He said until we find out, we’re going to put things on pause.

I got a call from the surgeon, and he said it was the metastatic form of malignant melanoma. He said don’t look it up and don’t tell your family, but make a call to the oncologist immediately.

Chris was diagnosed with mucosal melanoma

I got a call from the surgeon, and he said it was the metastatic form of malignant melanoma. He said don’t look it up and don’t tell your family, but make a call to the oncologist immediately and gave me the number. Since it was late on a Friday afternoon, I went ahead and made the call and got an appointment for the following Tuesday on the books. 

I did tell my family. I wanted to make sure I had support. I didn’t want to do any of it alone so they all came with me. We went to my first appointment and the oncologist said that this is very specialized. There are numerous types of melanoma, but since it is so specific, I need a second opinion. They recommended I go down to MD Anderson so I started making the calls for that and that’s what jump-started everything.

»MORE: How To Tell Your Family and Friends You Have Cancer

Did you have any additional symptoms? 

No, just the lump on my rectum and the one on my groin. The one on my groin ended up growing to the size of a golf ball. That was it. No fevers, no random sicknesses I couldn’t explain, or any aches or pains anywhere. It was just those lumps.

Sweaty rectum and two lumps near the groin were Chris's only symptoms

Chris received cancer care at MD Anderson

Against the doctor's advice, Chris told his family about his diagnosis

Dealing With A Diagnosis

Did you know much about melanoma pre-diagnosis?

Absolutely not. I was so in shock that you could get melanoma in places other than your skin. I’ve heard of cutaneous or skin cancer and anytime I’ve ever heard the word melanoma, that’s the association. The fact that you could grow melanoma where the sun doesn’t shine just blew me away. I was just shocked.

Chris did not know much about melanoma pre-diagnosis

How did you react to your cancer diagnosis

I had one moment where I bawled and cried in the shower one day. When I got out of it, I dried myself off and it was significant. I’m like, all right, starting fresh. I was thinking I’m just going to be overly optimistic and positive. That’s how I was going to approach everything and handle it all. I didn’t want to feel doom and gloom and have everybody around me be the same. I figured if I set the tone for everything, then that would jump-start between my family, my friends, and the doctors. 

I was thinking I’m just going to be overly optimistic and positive. That’s how I was going to approach everything and handle it all. I didn’t want to feel doom and gloom and have everybody around me be the same.

Chris chose to be optimistic about his diagnosis

I tell people that I had to come outside of my own self in a sense from whatever it was I wanted to be or do. I had to be so focused on gaining control because I felt so out of control. I don’t want to say hopeless or helpless, but you’re at a loss because this is so unique and different. They’re saying that this most likely could kill you. Everybody’s got an expiration date,  you just don’t actually know what it is. Getting told something like that is having them take the sand in the hourglass, flipping it over, and going, now the clock’s ticking. That’s how it felt.

What type of melanoma were you diagnosed with?

Being that I live up in Dallas and I got my initial diagnosis here, when I got down to the specialist, I had a second surgery. Once we knew what everything was, they removed the lump on my rectum and did a PET scan. When I got down to MD Anderson, that’s when he told me specifically that it’s mucosal melanoma and that it forms in the mucous membrane. 

The survival rate for those with mucosal melanoma is low, approximately 5 years

Anywhere you have, mucosa, whether it’s the vagina, rectum, ear, nose, and throat, that’s where it is, but it’s extremely rare. Mucosal melanoma makes up 1% of all melanoma and the survival rate is like 5 years, which is 14%. Since it forms in the mucous membranes and it’s always disguised either as a lump, a polyp, or a hemorrhoid it’s usually at stage 3 or 4 by the time it is diagnosed. I had local metastasis that went from my rectum to my lymph node so I was stage 3C as a diagnosis and eventually became stage 4 once it ended up going to all my different organs and everything.

How long did it take for your staging to advance?

After 4 months, Chris's staging advanced to stage 4

The 3C diagnosis was in July 2018. I had those 2 surgeries while I did a third surgery where they pull out all the lymph nodes from both of my groins and the remaining cancer that was still in my rectum. After I recovered from that, I did radiation and I got a scan at the end of November [that showed] it went from 3C to stage 4. Right after I finished my radiation to my rectum and I healed from all that, I went to go do another PET scan for staging and it didn’t come back to my rectum, but it went everywhere else. 

How did you process having cancer?

You could feel the vibe, having to fill out my will and do all that end-of-life stuff, it was intense. It was extremely emotional. I would have done anything in the world to stay alive.

Chris struggled with having to sign a will and deal with end-of-life protocols

I was clinically declining. It was a very sad situation in a sense, because the entire time throughout my treatment, I always had this optimistic positivity. Even though I was walking around with stage 4 cancer, you wouldn’t tell by looking at me because it riddles you from the inside when you do all the different types of treatments like immunotherapy. You don’t look sick like you do with chemotherapy or other types of treatments. I never really looked or felt until the very end of it. I had metastasized and was on a lot of narcotics actually, for all my cancer pain so I was kind of numbed to a lot of things.

I often tell people to imagine how high they can fly when they feel like Superman. That masked a lot of what was going on. But emotionally, I was torn up inside. I was so optimistic and so positive until I finally did start looking like I was clinically declining. You could feel the vibe, having to fill out my will and do all that end-of-life stuff, it was intense. It was extremely emotional. I would have done anything in the world to stay alive. If you said I need to drink a gallon of gasoline, I was going to do it. Whatever needed to be done, I was going to do it. I just looked at it like, I have no choice. If I’m going out, I’m going out trying.

When I even had colitis for 3.5 months due to all the immunotherapy treatment, that was the only time that I ever actually looked sick, because I’d lost so much weight. That’s the whole thing with this cancer. You’re walking around stage 4, terminal deal, but you don’t look like it. It’s just intense.

Treatment

Chris discusses the cancer treatments he was on for mucosal melanoma

Chris was on tumor-infiltrating lymphocytes (TILs)

Chris was on a combination immunotherapy

What other cancer treatments were you on?

Chris underwent chemotherapy for mucosal melanoma

They said their number 1 thing is always going to be immunotherapy. If there’s no cancer that showed up on my PET then I was going to do follow-up treatments. Because the cells are so small, they’re trying to travel so it’s a maintenance thing. It was like a year or so, they said, of doing immunotherapy treatments and a single dose sometimes mixed with chemo or something. That was my go-to as soon as it metastasized. We skipped that and went straight to combination immunotherapy of Opdivo and Yervoy.

»MORE: Types of Cancer Treatments

What side effects did you have from cancer treatments? 

I ended up having 3 surgeries to the same spot where that original lymph node in the groin was and then the lymph node dissection surgery. That exact same lymph node grew back in the same spot. I had 3 surgeries on the same spot on my leg, so I have nerve damage from my knee to my hip. My hair is all white and I used to have dark brown hair. The treatments completely wiped everything out and it came back including my eyelashes. I still have chronic pain and chronic fatigue. I deal with the immunotherapy treatments through my thyroid so I have hypothyroidism. I have to take medication for that for the rest of my life. I ended up having to do sperm banking right before my first radiation on my rectum because that was going to kill my chances of ever being able to have children.

Chris deals with nerve damage due to multiple surgeries on his leg

Chris dealt with losing hair pigment

Chris deals with thyroid issues which he takes medicine for

»MORE: Fertility After Cancer Diagnosis

The clinical trial and all my treatments completely wiped out all my melanocytes, so as my pigment is trying to come back I’m very susceptible to sunburns. I have to definitely wear UPF clothing, hats, sunglasses, long sleeves, and pants year round and a lot more sunscreen than I used to. Also, the immunotherapy treatments, caused uveitis right before I went into my clinical trial and I developed cataracts. I’d never even been to an optometrist or an eye doctor. I had perfect vision. I ended up having cataract surgery and now I need prescription glasses.

Describe your clinical trial

Imagine that your cells and the TILs are Pac-Man and you’ve got billions and billions of Pac-Man. They go throughout your body and they eat up all the cancer like all the dots and cherries until they’re gone. Once they do, it’s gone forever.

Chris was on an immunotherapy called tumor-infiltrating lymphocytes

The clinical trial is called TILs and it stands for tumor-infiltrating lymphocytes. It’s not where you just go in and get an infusion into medication. It’s a process. After you’re signing consents there are a series of tests to make sure you’re healthy enough to go through it. EKGs, blood labs, and things like that. You have to have more than 1 tumor of a minimum size so they can extract 1 and then monitor the other. What they do is they pull that tumor out and they send it out to a lab and then extract those cells and grow them into the billions. 

It’s a 22-day process prepping you to enter the hospital. You enter the hospital and get a PICC line in and you have to do 1 week of chemo that is a lymphodepletion. It brings your cell count down to 0 so your body’s like a blank slate. Then they take the TIL, they manufacture it into the billions and then they give those back to you intravenously. They follow that up with up to 6 doses of IL-2 interleukin. That jumpstarts the cells to get them to go. 

Imagine that your cells and the TILs are Pac-Man and you’ve got billions and billions of Pac-Man. They go throughout your body and they eat up all the cancer like all the dots and cherries until they’re gone. Once they do, it’s gone forever. It’s not in remission, it’s not asleep, it’s not waiting to wake up. It’s not there. If it was to pop back up, you still have all those billions of cells in your body of your TIL and they’ll be there forever and just eat it up. 

From start to finish, you’re looking at anywhere from a 3 to 4-week process, from the time you get your first surgery until you enter the hospital, then you do your week of chemo depletion. The hospital stay for me was about 12 days which is a minimum amount. It’s like taking the dial, turning it all the way down, and then turning it back up. All your levels and blood counts and everything got to come back for them to release you. While you’re doing that, you get the 6 doses of IL-2 after your TIL. That, I’d say, would be the last actual treatment that I ever did. I did the surgery and the chemo depletion, and they gave me my TIL and then IL-2 to follow.

How did you join this clinical trial?

I signed all my consents in November 2019, and I was actually supposed to enter the hospital in December 2019. Right before I entered the hospital, they found brain metastasis and it kicked me out of the trial. They said I might need to consider calling hospice and settling my affairs because the only way to get back in was to reduce or stabilize my brain metastasis. In order to do that, we needed radiation treatment, but the trial was closing. It was phase 2 and cohort 4. They had to wrap this up. They started the trial around 2015 or so. I was on a very strict timeline to get that fixed. The very last day for me to scan or re-scan to show that my brain metastasis was good was Christmas Eve. 

Chris raced to get radiation to his brain in order to rejoin the clinical trial

I ended up needing 5 doses of radiation. I went to the radiologist and saw them, but they couldn’t make the mask until I had the insurance approval. Once I got the insurance approval, I finally was able to make the mask but I didn’t have time to do 5 days of radiation. So I did it in 4 days. On the fourth day, they gave me a double dose. That was on December 23rd. Then I went and scanned on Christmas Eve and I had to wait and fill out my will and end-of-life things. 

I flew out to Colorado on January 2nd and saw the doctor on the 3rd. She said everything was all good. Well, not all good. It had pseudo-progression. It goes up before it comes down, but it was good enough to let me back in the trial. I entered the hospital on January 8th, 2020 started doing my chemo depletion on January 15th, 2020. That’s when they gave me my TIL and then I did my 6 doses of IL-2 and I was released from the hospital on January 20th, 2020.

What were the results of your clinical trial?

The clinical trial for mucosal melanoma was successful for Chris

In January 2021, a year to the date, they told me that I was able to get back into the trial. My scans showed that I did have a complete metabolic response. Nothing lights up on a PET anymore, everything is completely gone.

The way the trial works was, the day they gave you your TIL when you’re in the hospital, they call that day 0 or day 1. From then on, it’s 6 weeks you scan, and then 6 weeks after that, you scan. After that, you scan every 3 months. I started showing that everything was working on my scans. It wasn’t drastic marks, but it was either stable or in reduction, nothing new. 

Within less than a year, I want to say about 9 months, they started showing signs that I had a complete metabolic response. We followed up on my next set of scans with additional PET scans, along with my CTS and MRIs. In January 2021, a year to the date, they told me that I was able to get back into the trial. My scans showed that I did have a complete metabolic response. Nothing lights up on a PET anymore, everything is completely gone. There are a couple of spots, but they’re necrotic and calcified so they use those as the markers when I still go and get scanned every 3 months. That’s all I do now every 3 months, I go in and I get full body CTS, abdomen, pelvis, and also a separate one for my neck, and I do brain MRIs.

Life With Cancer

Chris discuss living with cancer

Believing in your healing

Chris discusses believing in yourself while healing

I just didn’t know how I was going to get there. I always saw myself like, you’re going to make it. You can’t really describe how you’re going to do it until it’s done. In my mind, I always thought I was going to make it. I never doubted at all that I wasn’t. As bad as everything got and hurt, I still was just like, if I was going out, I was going to go out with a legacy that people wanted to talk about. Other family members, doctors, and a lot of people told me they didn’t think I was going to make it, but I said, if I set the tone then everybody else will follow.

Describe your medical care team

I’d never been to an oncologist prior to this for any reason. I barely even knew what it meant. I had 3 different organizations I worked with and all of them were very receptive because I came in like this bubbly, positive, we’re going to beat this attitude and tone. Everybody was very receptive and welcoming. 

Chris liked his medical care team

I did have some doctors that thought they were so smart, but their people skills were not the same because they were in labs their whole life. I had a fellow that came and gave me the news that [the cancer] had metastasized. I had no clue, and he came in and told me like I already knew. That always kind of upset me. 

Advocating for yourself as a patient

I was very persistent on what I wanted and when I want it and had a sense of urgency. I used to be a home builder, and that’s what I was doing at the time when I was going through all of this. It was always my mindset if they’re scheduling anything, it needs to happen now, not later. I had a definite sense of urgency. If there was time in between, it seemed like wasted time. I was very persistent about always staying on top of that. Usually, everybody was willing to work with me on that. 

Chris recommends advocating for yourself as a patient

Chris had a sense of urgency when it came to treatments

Chris's doctors agreed he was capable of having multiple rounds of treatment

I was very well received in terms of getting my different oncologists to work with each other. They would prescribe my treatments down at MD Anderson, but if it was any chemotherapy or immunotherapy, I did that in Dallas. All my radiations and surgeries I would do down there. They were like, you’re young, you can take it in terms of all the treatments. I was like, yeah, let’s not wait till tomorrow. We can do it today.

I had a definite sense of urgency. If there was time in between, it seemed like wasted time. I was very persistent about always staying on top of that.

»MORE: How To Be A Cancer Patient Advocate 

Dealing with pain as a result of cancer

Chris took multiple medications to assist with pain

Most of the pains I have now, for the most part, they’re upper body, chest, shoulders, and neck. I was put on what they call a comfort pack, which consisted of a fentanyl patch, hydrocodone, and Dilaudid. When I was actually going through everything, I was up to a 75-milligram patch and then 240 hydrocodone once a month, which is like 8 a day, plus Dilaudid for breakthrough pain. After I had a complete metabolic response, I had weaned off the fentanyl patch and I never really took much of the Dilaudid because they just make you sleep. I reduced the amount of hydrocodone I took. I don’t have to take them all the time or every day, but if I need to, I still have some hydrocodone to take.

Is there a cause for mucosal melanoma?

Being that it is so rare and only makes up 1% of all melanoma, there are maybe 700 or so people a year in the US that get diagnosed with this, they don’t know what causes it. There’s no standard 1 treatment that works for all.

Chris did genetic testing to see if he had a genetic predisposition to melanoma

I did do the genetic testing and everything from the pathology, and I had a CDK4 amplification and an MDM2 mutation. It was like, all right, we’ll start here in terms of targeted therapy with the immunotherapies. The CDK4 is the same amplification that a lot of breast cancer patients have. Their initial thought was doing Keytruda, plus a chemo but it was always going to be in a combination of something because there was no one thing. It was, we’re going to try this and see how well that works. Then we move on to this. It felt like whack-a-mole.

Returning to work after cancer

I told myself I’m not going to make all my decisions in life based on money. I was working just to work, I wasn’t really living life.

I was a new home construction manager prior to now. When I was going through all my treatment, I was able to go in and out of work on short-term disability when I needed to. 

Chris was a project manager for new home construction pre-diagnosis

Chris returned to work post-cancer

Chris became dissatisfied with his work post-cancer

The thing with that career is there are long days, you’re walking houses, you’re in the truck, out the truck, the cold, the heat, and everything. When I got out of the hospital in January 2020, I had to go return to work by May 1st of that year. I was going to have to cover my insurance. It just didn’t make financial sense to cover my insurance because I have to maintain insurance. I was still on all those pain meds until I started reducing all that. It gave me a certain kind of energy. Once I started coming off of that and weaning myself down, I didn’t have that same energy.

I would go every day, but when I got home, if I didn’t eat and shower, I wouldn’t. I was so exhausted that I was just done. Come the weekends, I was still so beat up that I just didn’t want to go anywhere or do anything. Over time, I came to resent having to go back to work. Maybe it was what I was doing, because initially when I first got diagnosed, I was so busy with work that I didn’t take the time to go to the doctor and get myself checked. About a year ago, I departed from the job I was working at. I told myself I’m not going to make all my decisions in life based on money. I was working just to work, I wasn’t really living life. I was just working to pay the bills and rinse and repeat. 

Reflections

I feel like I’ve learned to live a more meaningful life because of the experience. I don’t have the physical or mental energy to want to go do what I used to do. The energy I do have, I want to put towards more positive good and being able to help.

Chris had a shift in values post-cancer that led him to want to do cancer advocacy

Finding new purpose in survivorship 

I was starting to tell my story more often and talk about everything and I could see the kind of reception I was getting, and it’s made me feel so good.

Chris has found a passion in sharing his cancer story

I refused to believe that I went through everything to not have it be of value. Not necessarily monetary value, but to the other people that want to have an example of, you got this too. What did you do? How did you come to the other side? I still don’t necessarily know how I’m going to do it, but I’d love to be an inspirational speaker. I want to be able to travel around and tell people about my story and go to conferences, and symposiums, work with foundations, clinical trial folks, survivorship, immuno-oncology, ASCO, SITC, and AACR. It’s just more meaningful. 

Long story short, I feel like I’ve learned to live a more meaningful life because of the experience. I don’t have the physical or mental energy to want to go do what I used to do. The energy I do have, I want to put towards more positive good and being able to help.

What advice do you have for someone on a cancer journey?

Chris set the tone around him by choosing to be positive

Chris reminds people that doctors work for the patient

Chris highlights having a sense of urgency when you have cancer

I always looked at it like I said, I was setting the tone and the positivity thing because I’m a big believer in, your mental well-being is connected to your physical well-being. They both got to be in harmony. If you’re in a place or position in your life and it’s causing you anguish and stress, it’s just not worth it. 

When it comes to cancer, it’s the whole sense of urgency and self-advocacy. You got to remember, you’re the ones that are paying the doctor. You’re the ones paying the oncologist. They work for you. You don’t just sit there and listen to them. I see the gaslighting, I see the ego, it’s all out there. Take control because it’s the patient to the patient. It’s not, the doctor says this and that’s the rule. Most of the time it’s the patients right now that are educating the doctors on this specific stuff. I meet with people weekly on Zoom calls and there are almost 20 people on a call. That’s probably more than any doctor has ever had in a room. Have a sense of urgency. If you’re not happy with what you’re doing, stop doing that.

The importance of getting checked by your doctor when something is off

Chris encourages people to get checked when they notice new symptoms

Just assuming it’s something when you don’t know for a fact, it can kill you. I tell people, have a sense of urgency, take the time, and make it a priority.

From the time I was diagnosed until the time we went through the clinical trial was 18 months. Within that 18 months, I had radiation to my rectum, my lungs, my kidneys, and eventually my brain. I had 3 major surgeries and then a fourth. Once I had my clinical trial, I did 2 different types of chemo and immunotherapy combo 6 times, and immunotherapy single twice. I was so intent on having something in my system that after the sixth dose of Ipi/Nivo, I had full-blown colitis and I probably had it going into that dose, but I lied my way into it. I did not mention my symptoms when they first popped up for the colitis, which was a reoccurring theme I found myself in. 

But if anything is ever off or wrong with your body, go get it checked, period. It doesn’t matter where it’s at or what’s going on. Just assuming it’s something when you don’t know for a fact, it can kill you. I tell people, have a sense of urgency, take the time, and make it a priority. I didn’t make it a priority when I was first diagnosed, or prior to that. That’s why it was diagnosed at 3C because I didn’t go. Anything that’s ever wrong, always go get checked. 

Chris encourages people to embrace the emotional side of cancer

Another thing is, it’s okay to talk about the emotional stuff. I just started doing that over the last couple of years. It was so rare, that people had more questions than I had answers for. 

I recommend anybody and everybody out there believe in yourself because you’re the one setting the tone. Definitely, if anything’s ever off, go get checked. Who cares about the consequences, take off work, do what you got to do, but definitely say something. Do something.

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